Cristina's Guestbook

Looks like my post got dropped.

I had a aortic valve replacement in 2020 with a Abbott labs regent valve. I was 57 at the time.

I had a bicuspid valve and aortic stenosis.

My decision was based on a few things.

1. I had fistula on my pulmonary artery that had to be removed, so they had to crack my chest anyway.

2. I was concerned about how long the TVAR would last. I wanted to minimize the risk of needing a 2nd surgery and being on anesthesia at a higher age the 2nd time.

3. To replace a TVAR my understanding is that they put a new cage holding the valve inside the old cage. That is a lot of material in that artery, that may have clot issues. I wanted once and done. Not a lot of data on cage in cage patients.

As to blood thinners. I had a rash at first, but my body adapted. No issues now.

Also have them test you for a reaction to heparin. It is really rare, but I had one during surgery.

Be praying for you,

William

Hi Cristina,
I’m sure you’ve figured out that there is not an answer that fits everyone. We can only share the decisions we made in hopes it may help you.
I had my bi-leaflet aortic and calcifying mitral valve replaced in December 2018 at the age of 58. Like most, if not all of the people who’ve commented, I was searching for the best,  nearest-perfect solution. Like you, I found there is no perfect solution, but fortunately, we have many good options.
I chose the On-X mechanical valves, since my dad had tissue valves that needed replaced every six years. Most people get more mileage out of them, but I figured my blood chemistry, is probably similar to his, and didn’t want to be facing re-operation so soon. I actually knew 10-15 years ago that I would probably go with a mechanical valve if my natural valve got to the point where replacement was necessary.
I rarely hear the valves. It seems people around me notice them before I do.

The blood thinner routine hasn’t really been an issue. I take the pills every day and I’m a little more careful, knowing my blood clots 2 1/2 times slower than it used to. With only one valve, you won’t need as much “thinning”. I also stop by the lab for an INR test monthly to make sure I’m on track. Being consistent in my intake of greens isn’t hard. It’s just something I have to keep in mind.
Another factor in my decision was that there is no guarantee you won’t need thinners with a tissue valve. Some people with tissue valves have to be on thinners anyway. I don’t know all of the factors that go in to that, but would talk to my doctor about that in case there is a test that could predict the likelihood of needing to be on a thinner, regardless of valve type.

Once I decided I was going mechanical, I started comparing them, and chose the On-X because it has been studied and had been proven to work well with less thinning. I also read about new materials that showed great promise, but were just not ready to be used in people yet. That was more than 3 years ago, so maybe there is something even better available now.
I hope I haven’t muddied the waters for you, and hope you’re able to glean enough information from all of our responses to help you make a decision you’re comfortable with.

Wishing you peace and a quick recovery.

Kevin







 

Hi Cristina , it’s a very hard decision. I went with the mechanical . I was 56 years old when I had a arortic replacement. That was 8 years ago . I did not want to go through the surgery again ,. I do not like taking warafin, but u get use to it . I wish you all the best in your decision. 

Cristina,

I was 58 when I had my AVR and also struggled with the decision. I decided I was too young and otherwise healthy to be on coumadin for the remainder of my life. Thus, I chose a tissue valve. It is now 12 years later and it is still going strong. Good luck and speedy recovery from your surgery.

First, good luck with your surgery, I hope and pray your team has the knowledge and skill for a successful procedure and that you know the peace of mind that this will bring. 

I had AVR almost 5 months ago; surgery went well and my recovery has been beyond my expectations. 

I am 65 years old and I chose a biological valve, for a couple of reasons.

1- Noise. My brother had a mechanical AVR ( at 55) and he said the clicking kept him awake some nights.
2- I didn't want to be on Coumadin forever. My brother was on it for 14 years and our mother was on it for 26 years.
3- my brother had a problem with his mechanical valve and required a second open heart surgery ( he replaced it with a biological valve). By the time I need to replace my biological AV, I'll have a TAVR instead of open heart surgery.

Good luck with your decision. Whatever you and your doctor's decide on will be the right thing for you.

I had aortic valve replacement surgery in April 2010. I was 63 at the time and very active. After consulting a couple of cardiologists and my surgeon, I chose a St. Judes mechanical valve. I questioned the cardiolgist about bleeding etc.. his comment was "just don't take up base jumping". I have not any adverse effects from warfarin, other than going once a month to have my INR checked. There have been many advances since I had my surgery. You have more information and other choices than I did. Know that whatever you choose it is the best for you. This website was a great help to me during my surgery and recovery. Best of luck.

Hi Cristina, I had my aortic valve, stem replaced plus an aneurysm taken out. I got an ony-x valve and I am on a low dose of warafin. No problems, I do not hear it tick.I definitely did not want to be on a blood thinner but  I was recommended to get this one for my valve is very small and to do the TAVR later in years my valve opening would be so tiny it wouldn’t be beneficial. I am 63 and hoping this mechanical will last the rest of my life Good luck with whatever choice you make! Thoughts and prayers .



  

Hi Christina, First let me suggest you get a second opinion before you make a final decision. Do not get a second opinion from the same office or hospital   A totally independent decision is important.  Secondly it is important to know that a valve repair is longer lasting than replacement and is preferable over replacement, because in most cases it lasts a lifetime . Ask if you are a candidate for a valve repair. The first surgeon I went to encouraged me to put in an artificial valve. My cardiologist did not agree. I ended up flying to Cleveland clinic where they too said they only put in an artificial valve, if they cannot repair the valve . When they repair your valve, they put in a permanent ring that lasts Best of luck 

I was 66 when I had my aortic valve replaced and I opted for the tissue valve by Medtronic, because I didn't want to be on blood thinners as I am very active and bruise already from the aspirin I'm on.  My valve is specifically designed so that when it fails I can have another one snapped into it via TAVR.

Hi again Cristina, Wanted to add that if you're understandably anxious about getting a biological valve and then having to have open heart surgery again if that valve wears out, keep in mind of the tremendous progress that's been made, and is ongoing, with valve replacement.  Though there are no guarantees, I'd say the chances are greater than good that if you do need another replacement, it wouldn't involve cutting you open again.  Check out all the articles on this site with cardiologists and surgeons who talk of all the latest advances in valve replacement surgery.  Best to you!

Hi Cristina, Regarding which type of valve to get, when you're told that with a mechanical valve you'll have to be on blood thinners the rest of your life, that's not the only possible negative.  From what I've heard, you'll also feel the valve clicking away inside you.  You might like that ("Hey, it's working!") or you might feel you've swallowed a clock.  (A blood worker told me he could hear the valve from across his desk when working with a mechanical valve patient.)  Also, you'll have to seriously monitor any leafy green vegetable intake, since they're rich in Vitamin K--the vitamin which helps clot blood.  So if you love leafy green salads as much as I do, that would be a real downer.  In any case, ask your surgeon and cardiologist about the things I've mentioned.  Every good wish for your surgery.  I've had it and I'm confident you'll do fine too!e

Hey Cristina, I was 57, and opted for the mechanical The deciding points were how long the tissue valve would last. And to me, more importantly the cage in cage implant. That is a lot of material in the aorta to possibly create clots, and there is not a lot of available research as to how well a cage in cage valve works in the long run. Not a lot of these done yet. Hope this helps.

I had a rash with the warfarin, but my body got used to it. Also, ask them to test you for a reaction to heparin. It is really rare, but I had one.

That is a very personal decision. I had mitral valve replacement at age 70 and decided that I didn't want to go through open heart surgery ever again. Because tissue valves have a potential low lifespan, I chose a mechanical St. Jude valve, knowing that I would be on Warfarin. I researched what the restrictions were on Warfarin, both food and meds, and decided I could live with them. The one thing I didn't anticipate and have learned since was that if I were to have anything that could cause  bleeding, such as colonoscopy, I'd need to come off Warfarin and give myself shots (scared me a lot). But, I still think I would have made the same decision if I'd known that. I self test my INR at home, usually every 2 weeks, and don't find that a problem.

Hello Cristina, 

I have had two aortic valve replacements.   I opted for tissue value both times.   The first time I received a porcine valve (pig) at 35 years old and it lasted 15 years.   For the replacement the surgeons suggested a mechanical valve so that I would not have (likely not) have to have a third surgery given my relatively young age.   Since I had such a great result with my first tissue valve, and did not want to take blood thinners or have the potential for clicking sounds, I saw no reason to rock the boat.   My second replacement was also a tissue valve (bovine).   It causes me no issues and when the time comes for a third replacement, I will likely go tissue value again too.   I wish you good luck in your decision.  You are in my prayers. 

I had a Ross Procedure.  Cumadin was the main reason. I was pretty young (early 40s) and was afraid a tissue valve would have to be replaced too soon.  I am from North Little Rock and had the surgery at UAMS but the surgeon who did it is no longer here.  The heart surgeon from Children's assisted as Ross Procedures are much more common with children.  Pretty sure he is gone too.

Hi Cristina,

I am a 51 and I have a St Jude Mechanical Mitral Valve and have been on Blood thinners for almost 18 years now. I had open heart surgery 11/06/03 (at 32) and I was not given a choice.  I find that all the brands are slightly different when it comes to side effects....Coumadin, Jantoven, and Warfarin. In the end I so wish I would of had a choice and I would choose a tissue valve over and over again. If I could have open heart again I would happily sign up for it tomorrow if I could get a tissue valve!

Good Luck with your surgery! 

Hi Cristina , 
I know you are very worried about what to do but only you can decide .
I have a st. Jude’s mechanical mitral valve and take daily warfarin . My surgery was probably very different to yours , I was dying and admitted as a emergency . I was in the late stages of heart failure . I had not been able to get a g p to see me face to face , during the start of covid / lockdown and ended up in a very bad way . 
I left it up to my surgeon , I just had to trust him and I am just grateful to be alive . Take care and try not to worry too much . Having the surgery is more important than the kind of valve or the  kind of surgery .

I’m 67… I had  aortic heart valve replacement surgery in October 2021…. I went for a tissue valve, bovine…. I just have to take baby aspirin daily…. Was told that would help the blood not to clot with the tissue valve…. I know they last 12-15 years but surgery should be less invasive next time… good luck …. My name is Diane 😊