Hey Justin, I am happy to discuss my valve choice with you. I chose bioprosthetic for a few reasons, the main two being (1) I am fairly active and play contact ...Read more
Hey Justin, I am happy to discuss my valve choice with you. I chose bioprosthetic for a few reasons, the main two being (1) I am fairly active and play contact sports regularly and I wasn't ready to give that up; (2) I went through the surgery once and know that I heal pretty quickly. Some of the other reasons may be a bit of "wishful thinking" but I am hopeful that the newer valves will last longer in young people and that TAVR will be much safer when I need my next valve. Finally, most of the people in the hospital said they would go with bioprosthetic if they were in my shoes.
I also put some faith in this article http://www.acc.org/latest-in-cardiology/articles/2015/03/03/09/28/surgical-aortic-valve-replacement-biologic-valves-are-better-even-in-the-young-patient
The current American Heart Association and American College of Cardiology (AHA/ACC) guidelines recommend that biologic valves are reasonable in patients aged 70 or above (Class IIa recommendation), whereas a mechanical valve is reasonable for patients below 60 years of age (Class IIa recommendation) 1. While the guidelines make clear that patient choice and willingness to take anticoagulation should be the major factor in deciding valve choice, these two recommendations reflect the dominating dichotomy in surgical valve replacement – young patients preferentially receive mechanical valves while older patients receive biologic valves. We provide the rationale for consideration of biologic valves as a primary choice for aortic valve replacement in adults below 70 years of age. Majority of data on biologic aortic valve replacement derives from studies of stented porcine and pericardial valves – we limit this discussion to these valve types. Separate considerations may apply to other biologic valve choices including stentless xenografts, and human valves (autografts and allografts).
