Miguel's Journal

Hello everybody!Hope you’re doing well!My name is Miguel, and I suffer from congenital aortic insufficiency. A few months ago, my cardiologist advised me to have surgery to replace the damaged valve. This operation may take place in a couple of months. I am currently 46 years old, and my main question is which type of valve to choose. My cardiologist recommended a mechanical valve, and I understand the underlying reasoning: mainly that I wouldn’t need hopefully another surgery down the line. The downside is the need for lifelong anticoagulation. I’m a healthy and athletic person, and I’m not sure how much being on blood thinners would limit me. Of course, I know I wouldn’t be able to play contact sports, but I worry that something like a fall while cycling or hiking could become much more complicated. Of course, I’ve also read about the risks that come with anticoagulants and the strict monitoring involved (weekly or monthly blood tests, depending on the case) to stay within the right therapeutic range. At first, I was leaning toward a biological valve, but after reading that these don’t last very long in younger patients and that I’d likely need another surgery in just a few years, I started having doubts. Especially since I’ve read that open-heart reoperations are more complex and riskier. I also don’t know whether a second surgery could be done via transcatheter (given my age and the duration of the disease chronic aortic insufficiency). I’d really appreciate hearing from anyone who has gone through this, especially if you had surgery before age 50. What kind of valve did you choose, and why? I’d like to know which kind of blood thinners exist. I read somewhere that there are “intelligent” blood thinners, so to speak, which don’t need a such strict monitoring. Do you have any news about it?Thank you so much in advance. Miguel