Kristen's Journal

Mark Jaycox  Hi Kristen, I was in the same predicament 5 years ago. I was the same age and had to choose between mechanical or tissue. I went with tissue because I did not want to be on blood thinners the rest of my life. I chose the Edwards Resilia Cow Valve. This valve was just FDA approved in 2017 and is supposed to last at least 20 years. If I need surgery again the valve is designed that I can have the TAVR procedure.  By the way I also had a bicuspid valve. This website helped me so much so I would encourage you to keep posting your journey. If you read my journal I'll bet you have gone through the same things. It's been over 5 years for me now and I feel great. You got this!!

Anna Ma  Hi Kristen, check out this video session Adam did with Ari and Dr Roselli. I went through almost the same research and thought process in making my decision. It was good for me to watch this and got the confirmation on my decision. I'm a few years younger than you, I'm going for Resilia valve too. According to my research, Europe has now recommend bio valve for patients older than 50.  https://youtu.be/mbVTFGTOZjY?si=KCXJyyxfC84Iw781

Luke Rodriguez  So I was the same age as you and my surgeon recommended a mechanical valve which is what I ended up getting because like you, I really did not want to be opened up when I was much older and less able to tolerate another procedure. 

I have had my valve for almost 2 years and here is the downside at least from my experience.  
First is heart palpitations....especially when I sleep.  If I sleep on my left side...my favorite side...I am very aware of the pounding of my heart which I am told is common. I often wake up on that side and it really doesnt hurt anything to sleep on that side...just the pounding kind of bothers me.  At this point, I really have to think about it to notice it....and....if I engage my core, it weirdly goes away. 

Second is the sound...I thank God I wear hearing aids because in a quiet room you can hear your valve ticking. Since I am hard of hearing, I don't hear it at night and I always run a fan to drown out the clicking so my wife doesnt hear it.  But a quiet room like a doctors office I can hear it clearly....so can the doctor, LOL.

Recovery was no fun for me.  I work out and was exercising regularly at the gym and because I had a good amount of muscle on my chest, that made recovery very painful.  Weeks after surgery I could look at my chest and it was constantly vibrating...muscle relaxers actually helped more than pain meds. 

So two years post surgery I go to the gym four days a week, the only limit my doctor put on me was to not bench press more than 200lbs.  I take a body pump class twice a week and a spin class twice a week and my heart rate can go up to 150bpm and I have zero symptoms...my energy level is great and my stamina has been remarkable high...I never knew how bad I was doing until I knew how great I am doing now.  

Yes, I take warfarin every day...but I take a statin, fish oil, other supplements and it goes in to my daily meds that I take anyway.  I never had any issues with bleeding or anything like that.  I have my own INR meter so I can check my blood at any time.  The only time it ever shifted was from antibiotics....stay away from Zpacks.  Otherwise, I am glad I went this route. 

Hope this helps. 

john roland  Kristen, I had a bicuspid aortic valve and aneurism that was being watched for 6 years. I started the 'watch and wait' at 52 and at 58 I had the surgery. I did alot of research and chose Dr. Roselli at the Cleveland Clinic to do my surgery. He has a great personality and we talked at length about which valve to choose and why. In the end I asked Dr Roselli, " if I was your brother what valve would you recommend". Right away he told me to get the Edwards Resillia tissue valve. It has been 4 years since I had the surgery and I never looked back. I am still very active and that is a big reason why I avoided the mechanical. Its a personal choice but I can tell you the few times I have had accidents in my wood shop I am glad I wasn't on a blood thinner. Good luck

Dan Fouratt  I am slightly older but going with the Edwards valve. My plan is Edwards for 15 to 25 years followed by a TAVR for another 10 to 15 years (hopefully more in the future) and I figure by then they will have the TAVR in TAVR figured out. 

Rita Savelis  I had my aortic and mitral valves replaced with mechanical valves at age 53, 9 years ago. Because my valves had radiation-induced stenosis (from radiation treatment I had for cancer at age 15) I was a difficult case and having a second surgery in the future was to be avoided if possible. Getting used to anticoagulants can take some time at the beginning as your body adjusts. I eat what I like and haven't changed my lifestyle. I have a blood test about once a month or whenever I choose to.  I don't hear my valves ticking unless it is very very very quiet in the room. It has never bothered me. I used to put a pillow on my chest if it was quiet and I was reading. I am sorry that you have to make this decision about valve type because it is a difficult decision for everyone and there is no right answer. Everyone's body and heart problem is singular and different. Whatever decision you make will be the right one for you, and then you move forward. If there were a right answer everyone would be following it, but instead there are myriad ways of reacting. Hopefully your doctors can guide you. I feel for you because I remember wishing I were in my 70's when I had heart surgery rather than in my 50's. Take care.

Pamela Gregory  Hi Kristen, I had my Aortic valve and root replaced at age 55 by Dr. Roselli in Cleveland. He did the root because it was narrow and my valve was very small and bicuspid. Got the Edwards Biological Valve because I did not want blood thinners. I am hopeful for this valve to last for a long time since it is larger and Dr. Roselli said it is not having to work very hard which is good. He is hoping for 15-20 years. It was a really hard decision for me but I am glad I did what I did. Good luck with your decision. Also, the Replacement valve has to be large enough to have TAVR in the future. Hope this is helpful

Daneen Douglas  Hi Kristen!  I’m 52 and will be getting my surgery in about a month and a half from now.  My surgeon says about 50% of surgeons will recommend biologic valve and 50% will recommend mechanical valve.  Yes, we are in that grey area.  It really is a personal choice and depends on your lifestyle.  My surgeon knows very active people who are into competitive sports who have chosen both types of valves and are happy with their choices.

 For me, I am choosing a biologic, most likely Medtronic Freestyle bovine biologic valve, which will replace my root as well as my aortic valve.  It will also accommodate a TAVR down the road. I am also getting my ascending aortic aneurysm replaced.  This valve is often used in combination with this procedure.   My surgeon says they are lasting 19 years so far and may last longer but they are only 19 years old, lol. Also, I’m super clumsy and like to cook.  I cut myself often and like to hike and be active.  For me, I didn’t want to deal with blood thinners, the loud noise of the valve, and inability to get some types of tests, ie; MRI’s, etc..

 My mom is living with two mechanical valves and has had many complications.  I do not want to deal with that.  So, for me it was an easy choice.  Good luck with your decision!

Sean Adkins  I'm 52 years old. My bicuspid aortic valve was replaced with the Edwards Inspiris Resilia tissue valve. My surgeon was Dr. Lars Svensson at the Cleveland Clinic. The study I point everyone towards showed 25 years of simulated accelerated wear with no breakdown in the valve or the Resilia tissue. Edwards was getting on average 19.7 years in the previous generation of valves that didn't have the resilia anti-calcification treatment so I'm hoping for 25 years or more. The valve also uses Edwards V Fit technology which makes it capable of receiving a future TAVR valve if or when the valve does fail. 

Long-term durability of a new surgical aortic valve: A 1 billion cycle in vitro study - PubMed (nih.gov)

Dan Fouratt  Daneen, after reading the above earlier i specifically asked my doctor and will be getting that valve.  The test results were absolutely amazing.

Daneen Douglas  Ok well that is great to know!  I will be bringing this valve to his attention on the19th!  Thanks Dan!

Daneen Douglas  This video was awesome!  I may reconsider my operation and do a SVR again instead of a TAVR.  Great information and technology is a crazy ever evolving thing! 

Grace Mason   Hi Kristen, I was 56 when I had my surgery 6 months ago. I originally thought I would go with a replacement if I could not get a repair. I would have liked to preserve the native structure of my heart but I had too much calcium buildup. New tissue valves do sound promising but after I read Dr El-Hamamsy's research paper on living valves, that made me seriously consider and then choose a Ross procedure. I was entranced with the thought of having a living valve as opposed to non living, in the so vital position of the aortic valve. My pulmonary valve as a mirror image of the aortic valve, could learn to act as an aortic valve, building the same proteins as your native aortic valve over time, because it is your own living tissue. I also felt it would provide more natural hemodynamics than any created valve could and would afford me my same active lifestyle and hopefully last longer than a bio prosthetic valve in the aortic position. This is why I ultimately chose Ross, but everyone is different and it is a very personal decision. Wishing you well and peace in your decision.

Meredith Bray  I was 43 and went with mechanical 10 years ago. I think everyone struggles a bit with anti-coagulation for the first 6-12 months. I had a fabulous coumadin nurse at my cardiologist, and we settled in to a rhythm of testing about every 5-6 weeks. I have not had any lifestyle change and no noticeable increase in bleeding (with the exception of the 2 years before menopause started - those were hellish! but that may have been a girl thing and not a coumadin thing). Whichever valve you choose will be the perfect one for you.

Meredith
Oak Ridge, TN

Luke Rodriguez  I saw in the comments that you cannot get an MRI if you have an artificial heart valve. This is news to me since I have one and have had two MRIs with no issues. 

Dan Fouratt  Luke,  I asked that question as I have a brain tumor being monitored with annual MRIs.  With the biological valve it was not an issue with MRIs. 

Rita Savelis  No problem with MRIs. I have 2 mechanical valves and a pacemaker. The mechanical valves are not an issue. A rhythmologist (cardiologist) adjusts my pacemaler before and after the MRI. Have had many MRIs in the past 9 years.