Anne's Journal

George Allen  I am in the same boat as you and the same age.  I have done a lot of research and analyses on this and you will find a lot here.  Here is my own assessment of this.  I have chosen to go with a Bio Inspiris Resilia valve (27 or 29 - ie the largest they can fit) over a mechanical but have not yet picked the hospital/surgeon.  The pros of this valve are i) no blood thinners, ii) it's the latest tech that limits SVD (structural valve deterioration) and has durability that should last 10-20 years iii) as I can fit a larger valve it is designed to allow for future TAVR valve in valve procedures when it fails. The negatives are i) 100% chance of reintervention in my lifetime, ii) higher risk of infection - future endocarditis etc.. For a mechanical valve i) it lasts longer and could (not guaranteed) last the rest of your life i.e. one and done on the surgery. The downsides are i) you need to take blood thinners - even if it is the new On X valve that has a lower INR, ii) on blood thinners you need to watch what you eat, monitor your INR levels and get tested frequently and also be careful with activities as there is a higher risk of stroke and blood clots, ii) it makes noise and you can often hear the valve. So why did I chose the Bio valve?  Well for starters I don't want to be on blood thinners - an acquaintance of  mine was on them - was walking her dog - tripped and hit her head - rushed to the ER and died of a brain bleed - Blood thinners and head injuries are not a good combo, Secondly, I could not tolerate the ticking noise as  for me that would drive me crazy). I am also willing to take the risk that I will be healthy enough for a repeat SAVR in the future and if not that a valve in valve will be an option.  I am also banking on continued innovation on this area so who knows what options will be available in 10+ years.  Lastly, I also did consider a Ross Procedure but already have some pulmonic regurgitation, so I am scared of just moving that issue to the Aortic position and creating more issues for me. Ross is a great option but for me messing with more valves in my heart scares me.  This is a very personal decision and once made you have to accept it and go with it with no regrets or looking back.  Unfortunately, none of them are perfect.  I Hope this helps and appreciate any other views on my thinking here as like you I am finding it to be a very difficult decision. 

Robert Miller  I didn't read all of George's post but from glancing over it, I think he covered all the essential points. The usual recommendation is below 50 get a mechanical valve, above 50 get a pig/cow valve. But a lot also depends on the individual, any other underlying health issues, etc. Also check out the learning center. There is a good amount of information there about this topic. Scroll down to the bottom to see the actual links. https://www.heart-valve-surgery.com/learning-center.php 

Grace Mason   I had a hard time deciding as well. I was same age as you. We are kinda in the undefinable age range of what is best. After researching and reading I opted for Ross at Mt Sinai. Hoping for more than 10 yrs and ideally 25 plus before another intervention is needed🤞🏼 Going for a 1 yr follow up soon and feeling good.

Rita Savelis  I'm not promoting a mechanical valve (although I have 2 placed at age 52, 9 yrs ago) but i don't hear any noise from mine (unless it is very very very quiet), I have a blood test when I want (about once a month) and control my own meds, I haven't changed my diet and eat everything in moderation. I haven't changed my lifestyle. All this to say that valve choice is a personal choice and whatever choice you make will be the right one for you at the time. This is a hard decision for everyone. There are pluses and minuses for both.  Sometimes your surgeon can help. My heart was irradiated by cancer treatment as an adolescent so having more surgery was not advised for me. Everyone has a singular heart situation.

Marie Myers  That was a very hard decision for me. After months of going back and forth, i decided on a tissue valve. My choice was mainly one for staying off Coumadin. I do, however,  know someone who has had his mechanical valve  for 40 years now.  Now that is some longevity!

Rose Madura  Ann, it's a very personal and extremely difficult decision. I was 59 and went with a tissue valve with expectation of TAVR in the future.  I too wanted to avoid blood thinners but I was on the fence for a long time about what to do.  My brother (a doctor) and my surgeon discussed pros and cons of both which helped.  Anyway, whatever you decide, don't second guess yourself. It will be the right decision for you.

Robert Miller  Unrelated but I got confused for a second thinking the post from Grace is Anne responding to herself, which made no sense... With these small profile picture Anne and Grace look pretty similar...

Maggie Ma  I got my OHS at age 53 this year. At that age, neither option is definitely better vs other one. It was difficult decision for me and I was back and forth for quite some time. I made my final decision just a couple of weeks before my surgery. I finally decide to use Mitris Resilia tissue valve. Doctor implanted tissue valve with big size 29mm for me, which can fit valve in valve procedure in the future. I'm hoping this valve can last 15+ and also hoping new technology of valve in the coming 10 years. Main reason for my decision is lifetime blood thinner for mechanical valve. I'm
Not sure I can remember to take it every day and also maintain IRA within the right range consistently. In addition, my concern is when I become older later on  and the probability of fall incidents may increase which leads to higher risk of bleeding

it's personal decision. No matter which one you choose, it'll make your heart better and stronger ❤️

Pamela Gregory  Definitely the hardest decision!!! I opted for tissue valve at 55 years old for the usual reasons. I think potential ticking would drive me to the looney bin and did not want blood thinners. That being said I do not want another procedure but I am comfortable with the choice I made. It is personal, you have to weigh what is right for you, and then do not look back

Darrell Malone  Hi Ann, it can be overwhelming on deciding what is best for you. I had the Ross Procedure April of this year I am 55. Maybe you want to check into this and see if you are a candidate for it. For me it was always the one I wanted and almost 5 months now I am doing great. All the best. 

Daneen Douglas  I was 52 almost 53 when I had my replacement 4 months ago.  I went with a biological valve due to my clumsiness factor, always cooking, and love to hike and explore.  I didn’t want to be tied down to INR tests regulating blood levels and also watching certain foods at certain blood levels.  On the other hand, I will most likely have to get another surgery in 15-20 ish years(fingers crossed).  They made sure I am able to receive a TAVR at the very least when that time comes.  Technology is also always advancing.  Ultimately it is definitely a personal choice.  There are positives and negatives on both sides. 

Suelynn Hanegraaf  Hi Ann, I went with bioprosthetic valves for both of my aortic valve replacement surgeries at age 53 (bovine) and at age 67 (porcine) 4+ months ago. The second one - like Daneen’s - was prepped for TAVR when I go for the 3rd time. It is such an individual decision. For me, I did not want to take blood thinners and the testing. 💕 And I am happy with my choice. 

Rich Butela  I was 61 last year and opted for the tissue valve.  I didn't want to be on blood thinners the rest of my life. I like to work with my hands and am constantly cutting or scratching myself, so it was an easy decision for me.