Theresa's Journal

  I've been on warfirin for a long time. Consistency in my diet and somewhat avoiding green leafy vegetables (vitamin K) has kept me pretty steady with my levels. Having to go for blood test every two weeks (or more) can be a pain but there is also a home testing system your doc can write a prescription for. Personally I'm opting for the mechanical valve as I do not want to risk going thru surgery again.

Emily Rowley  Hi Theresa, Welcome to the community ☺
Like you I placed alot of thought and time into what valve to choose. Ultimately the decision lays in your hands, however talking with your Surgeon (they may have preferences like mine did Pig's Valve for Tissue) and Cardiologist about this and your individual heart condition is important as well. Being on Coudamin was not as tough as I imagined it would be or when I read up on the internet (not always the best idea esp with upcoming surgery), I kept mine stable quickly (except when sick) as I did monitor my diet/green vegetable intake, for me it was my menstrual cycle the hardest. They will make advances in medical technology in the future, so keep this in mind. I wish you all the best, whichever you choose.

Theresa Feiereisen  Thanks so much for the info. I am leaning toward the mechanical valve also because I do not want to have surgery again if I don't have to. Also like you said there are advances all the time in medical technology. I know that it is better taking the medication now than it used to be. I do like my green vegetables so that will probably be my biggest issue since I no longer have to worry about the menstrual cycle part.

Denise Campbell  Theresa my Coumadin clinic tells me as long as I eat vitamin k foods consistently, they will adjust your meds to it. I have adjust and leveled out You will need to get your blood (inr) checked weekly for a while. Then monthly. Good luck I chose mechanical for the same reason your thinking about

Joanna Prisiajniouk  I understand TAVR will be a simple tissue replacement without OHS if you want to avoid Coumadin now and then TAVR in the future. Mechanical valves (knock on wood) could fail too. If it dies TAVR is not an option. The valve in valve (TAVR) can be repeated a few times too. Talk to your surgeon about this as well as it will be approved soon with even better results. They are doing great now.

Denise Campbell  On x mechanical valves have been around for over 12 years and have no reported failures ever. And mechanical valves have been around for many many years with failures being very rare. Coumadin is a pain in the behind but so is multiple surgeries. So sacrifices for both in order to stay alive

Denise Campbell  I went back to the article I read about TAVR. I did Mis read. Maybe someday they can do it for mechanical too.

Iloka Wickremasinghe  Yes since you are young a mechanical valve means it will last much longer. I opted for a tissue valve ( I was 50) when I had my surgery in the hope that when I do have to replace it science would be more advanced and hopefully I would be able to have it replaced through a keyhole surgery. However the surgeon was able to repair my valve so all good. I wish you all the best.

Kate Watson  I just had my second OHS and chose mechanical valves this time, partly because I needed two, whereas before I got one. I think clearly some people handle the emotional and physical stress of having heart surgery better than others. Having had this twice and choosing a tissue valve the first time, I now know what both sides are like. I don't regret having a tissue valve the first time but it was pretty rough on me when it failed after 10 years because I expected more life out of it. They say now it doesn't last as long in younger people. For me, having a failing heart and impending open heart surgery was extremely stressful and all consuming both times for myself and my family. The recovery process is no picnic and has been difficult for me both times. I got consults with several surgeons and they all recommended I go with mechanical this time. I could have pressed on and found a surgeon who would have done two tissue valves. But my risks for a re-operation would be extremely high. And I personally did not want to go through this whole process ever again if I could avoid it. As for Coumadin, I am primarily vegetarian and already have dietary limitations due to digestive issues. So I was quite concerned about taking it. But as Debbie said, the Coumadin clinic should dose it around your diet. If anyone tells you that you have to give up greens, that isn't correct. As others have said the key is consistency with intake of Vitamin K. You don't want to go crazy with it but you can still have those foods. I am a dietitian so it makes this a little easier on me but it's still been an adjustment process and still trying to get my dose and diet right after 2 months. I think it's really really important to weigh all the pros and cons and risks of each type of valve for your individual situation. I'd be sure to ask your surgeon about your expected risks for when you need to have a re-surgery. I also think you have to go with your gut on this to some extent too. Wish you the best in making this decision. Please feel free to ask me any other questions.

Emily Rowley  With Coudamin you can eat as much greens as you want, just try to keep the amounts consistant (I have a booklet which is very useful I can send you the link), however your Dr can alter the dose ☺ It is a hard decision, so take your time. I believe I would probably still be debating/thinking of whether I made the right decision with my choice of valve today if I had a replacement. I was lucky enough to have a re-repair (2nd OHS) and told due to my heart's anatomy I could not have a tissue valve only mechanical valve-great reason to talk to your Surgeon ☺Also there was a lady in my ward with Tissue Valve Replacement who needed life long anticoagulants. I was thinking you may not need to worry about the menstrual cycle part-lucky you! 😁 Here to help, love to hear any questions you have.

Jean Raber  I'm 62, and would not opt for mechanical valve because both my parents had major GI bleeds on long-term coumadin. When they were in their 80s. I also expect I would die before the tissue valve gave out. At 49, there might be more pro's to consider with a mechanical valve. You can hope that heart surgery will be less invasive if you need a tissue valve replacement. Yes, new techniques are being developed all the time. Will you have insurance coverage that will pay for the latest and greatest if that day comes? The bill will be crushing if you don't ... and some centers won't take you if you have inadequate coverage. More food for thought.

  Best wishes on your decision. I chose tissue. My surgeon implanted a slightly larger valve with plans for me to have a TAVR replacement next time. I take 81 mg of aspirin daily and have to take antibiotics with dental cleanings. Otherwise, all is well. You can read more of my story on my page as to why I chose tissue. Good luck to you!

Dan Edle  I had mitral valve surgery with Dr. Raymond Singer at Lehigh Valley Hospital in Allentown, PA on March 4th. Luckily Dr. Singer was able to repair my mitral valve by OHS with an implanted device... annuloplasty ring from Edwards Lifesciences. If he was not able to repair my valve I chose to have it replaced with a tissue valve since I didn't want to be on Warfarin for the rest of my life. I was on Warfarin for about 5 weeks after my surgery, and did not enjoy the experience.