{"id":3962,"date":"2023-10-30T12:41:51","date_gmt":"2023-10-30T12:41:51","guid":{"rendered":"https:\/\/www.heart-valve-surgery.com\/learning\/?page_id=3962"},"modified":"2025-05-29T22:09:19","modified_gmt":"2025-05-29T22:09:19","slug":"bioprosthetic-mechanical-valves","status":"publish","type":"page","link":"https:\/\/www.heart-valve-surgery.com\/learning\/bioprosthetic-mechanical-valves\/","title":{"rendered":"Bioprosthetic Versus Mechanical: Which Valve is Right For You?"},"content":{"rendered":"<p>Patients with a significant heart valve defect (e.g. aortic stenosis) are often not candidates for a heart valve repair procedure. Instead, they will need to have the diseased valve replaced. A valve replacement procedure requires some decision-making since there are different options. First, there are bioprosthetic valves, including <a href=\"https:\/\/www.heart-valve-surgery.com\/learning\/pig-valve-replacement\/\">pig <\/a>and <a href=\"https:\/\/www.heart-valve-surgery.com\/cow-valve-replacement.php\">cow valve replacements<\/a>. Alternatively, there are mechanical valves made from <a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC4526499\/#:~:text=Mechanical%20heart%20valves%20are%20made,place%20of%20the%20original%20valve.\">titanium and carbon materials.<\/a><\/p>\n<p>Bioprosthetic and mechanical valves have critical differences and distinct advantages and disadvantages. Every patient should know and understand all the facts before deciding which type of valve to use for a replacement since it will be part of them for many years, and sometimes, for the rest of their life.<\/p>\n<p><a href=\"https:\/\/www.heart-valve-surgery.com\/surgeons\/dr-Marc-Gillinov-Cleveland-Ohio.php\">Dr. Marc Gillinov<\/a>, Chair at the Department of Thoracic and Cardiovascular Surgery at the <a href=\"https:\/\/www.heart-valve-surgery.com\/hospital\/cleveland-clinic-microsite\">Cleveland Clinic<\/a>, weighed in to provide insight into valve replacement options and what patients need to consider when making that important choice.<\/p>\n<p>&nbsp;<\/p>\n<p style=\"text-align: center;\"><iframe loading=\"lazy\" title=\"YouTube video player\" src=\"https:\/\/www.youtube.com\/embed\/lVymPXiZRSw?rel=0?si=vKwpf9KPhhF7mSnA\" width=\"560\" height=\"315\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><\/iframe><\/p>\n<p>&nbsp;<\/p>\n<h2>Key Learnings About Heart Valve Replacements<\/h2>\n<p>Dr. Gillinov shared several vital insights in this video. Here are the key takeaways for patients to consider when learning about heart valve replacement options:<\/p>\n<p>&nbsp;<\/p>\n<p style=\"text-align: center;\"><picture><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-full aligncenter\" src=\"https:\/\/www.heart-valve-surgery.com\/profileImages\/167_129_172.jpg\" alt=\"Dr. Marc Gillinov - Robotic Mitral Valve Repair Surgeon\" width=\"129\" height=\"172\" \/><\/picture><a href=\"https:\/\/www.heart-valve-surgery.com\/surgeons\/dr-Marc-Gillinov-Cleveland-Ohio.php\">Dr. Marc Gillinov, Chairman of the Department of<br \/>\nCardiothoracic Surgery at Cleveland Clinic<\/a><\/p>\n<p>&nbsp;<\/p>\n<h2>Repair versus replacement<\/h2>\n<ul>\n<li>Surgeons at the Cleveland Clinic perform over 2,000 heart valve operations each year. Before every surgery, the doctor and patient discuss the type of heart valve surgery and whether it will be a valve repair or a replacement. \u201cIn almost all cases of mitral valve prolapse, which causes a leaky valve, we can repair the valve,\u201d Dr. Gillinov said. \u201cIn contrast, when patients have aortic valve stenosis, meaning the valve is narrowed, that would be replaced.\u201d Dr. Gillinov stressed that surgeons always discuss a valve replacement, even if the original plan is to repair a valve. \u201cOccasionally, we find a valve that we thought we could repair, but there is so much damage that we have to replace it. In every heart valve procedure, a discussion of valve replacement is absolutely necessary.\u201d<\/li>\n<li>After discussing the possibility that plans may change and a repair procedure may turn into a replacement procedure, Dr. Gillinov believes the following question to be answered is, \u201cWhat kind of valve do I want?\u201d There are two types of valve replacements: mechanical valves and bioprosthetic valves. \u201cSome people call mechanical valves metal valves,\u201d said Dr. Gillinov. \u201cThey\u2019re actually made out of carbon more than metal, but they do have some metal in them.\u201d<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<h2>Mechanical valve facts and features<\/h2>\n<ul>\n<li>When considering a mechanical or bioprosthetic valve, Dr. Gillinov said, \u201cI think the most important point to know is that they are both very good, but there are key differences. Mechanical valves usually last forever. They almost never wear out, and it is uncommon for someone with a mechanical valve to need a reoperation ever in his or her life.\u201d<\/li>\n<li>Unfortunately, Dr. Gillinov points out, mechanical valves \u201ccome with some baggage.\u201d Even though mechanical valves are durable, their &#8221; baggage &#8221; includes anticoagulation or blood thinners. \u201cThat anticoagulant has to be Coumadin, which is also called warfarin. The reason why mechanical valves require an anticoagulant is that they tend to cause blood to clot on the surfaces or discs of the valve,\u201d said Dr. Gillinov.<\/li>\n<li>Gillinov points to three essential issues patients must know when choosing a mechanical valve. The first is that an anticoagulant thins the blood, putting a patient at greater risk for bleeding. Next, when a patient is on Coumadin, it requires a monthly blood test to check that the medication level in the blood is within range. And finally, mechanical valves make a slight clicking noise. \u201cIt\u2019s not loud, but almost anyone who has a mechanical valve inside their heart can sense or hear this small click it makes every time it closes.\u201d<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-full wp-image-3972 aligncenter\" src=\"https:\/\/www.heart-valve-surgery.com\/learning\/..\/Images\/mechanical-valve-replacement-patient-consideration.jpg\" alt=\"Mechanical Valve Replacement Considerations\" width=\"650\" height=\"358\" \/><\/p>\n<p>&nbsp;<\/p>\n<h2>Bioprosthetic valve facts and features<\/h2>\n<ul>\n<li>Bioprosthetic, also called biological valves, come from pigs or cows. \u201cThe pig valves are actually pig aortic valves, which are mounted on a sewing ring or circular ring,\u201d Dr. Gillinov said. \u201cThe ring has the valve in the middle; we sew that ring into the heart.\u201d<\/li>\n<li>The cow, or bovine valves, are made from the lining of the cow\u2019s heart, called the pericardium. \u201cThe lining, which is leather-like material, is fashioned into a valve. Both kinds of valves work very well, and there is little difference between them, \u201c said Dr. Gillinov.<\/li>\n<li>Two main features of the bioprosthetic valves differ from the mechanical valves. First, bioprosthetic valves don\u2019t require blood thinners. \u201cHowever, the pig and cow valves can wear out,\u201d Dr. Gillinov points out. \u201cThey almost always last at least ten years; we\u2019ve seen as long as 22 years. It\u2019s uncommon for them to wear out in five or six years.\u201d<\/li>\n<li>Interestingly, the older the patient, the longer the bioprosthetic valves last. \u201cIf you\u2019re 65, and you get a cow or pig valve, there\u2019s a very good chance it will last your whole life,\u201d Dr. Gillinov told us. \u201cSome people in their 50s will choose a pig or a cow valve because they don\u2019t want to be on blood thinners. That means when these people get into their 60s, they will likely need a new valve.\u201d However, Dr. Gillinov points out they may not need surgery to replace the worn-out valve. \u201cThere\u2019s a good chance we can take a new valve, crimp it, or fold it like an umbrella, thread it up a vein or artery from your leg, and deploy it in the housing of the old pig or cow valve because the old valve gives a perfectly circular landing zone such that we can put a new valve inside.\u201d He said there\u2019s no guarantee a 50 or 60-year-old patient won\u2019t need surgery if they choose a bioprosthetic valve, but there is a good chance they won\u2019t.<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-full wp-image-3973 aligncenter\" src=\"https:\/\/www.heart-valve-surgery.com\/learning\/..\/Images\/biological-valve-replacement-patient-consideration.jpg\" alt=\"Biological Valve Replacement Consideration\" width=\"650\" height=\"364\" \/><\/p>\n<p>&nbsp;<\/p>\n<h2>Which valve should you choose?<\/h2>\n<ul>\n<li>Gillinov believes that both valves are very good. \u201cThe blood flow through a mechanical valve is a little superior to that of a biological valve, but it\u2019s generally not significant,\u201d he said. One study from California from the <em>New England Journal of Medicine <\/em>published data that people in their 40s and 50s may live longer when they have a mechanical valve replacement instead of a biological valve. But Dr. Gillinov said, \u201cPeople should choose the valve based on their lifestyle, wishes and needs. If you are 55 years old and your favorite activity is bicycle riding, and you ride in races, and you are often knocked off your bike, essentially you get beaten up and bruised, and you don\u2019t want to be on a blood thinner, a biological valve might be best for you. If you\u2019re 70 years old, you should almost certainly choose a biological valve because that valve is likely to last your whole life.\u201d<\/li>\n<li>\u201cThe key point here is it\u2019s a discussion,\u201d Dr. Gillinov said. \u201c A discussion between you, your needs, and the surgeon and what he or she thinks might be best for you. At the end of the day, both of these types of valves, mechanical and bioprosthetic, are excellent choices.\u201d<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<h2>Thanks Dr. Gillinov and The Cleveland Clinic!<\/h2>\n<p>On behalf of our patient community, many thanks to Dr. Marc Gillinov for sharing his<\/p>\n<p>knowledge and expert insight about the differences between mechanical and bioprosthetic valves and what patients need to know before deciding which one is right for them. Also, we want to thank The Cleveland Clinic for continuing to take great care of heart valve patients.<\/p>\n<p>Related Links:<\/p>\n<ul>\n<li><a href=\"https:\/\/www.heart-valve-surgery.com\/surgeons\/dr-Marc-Gillinov-Cleveland-Ohio.php\">See Dr. Gillinov\u2019s Surgeon Profile and Patient Reviews<\/a><\/li>\n<li><a href=\"https:\/\/www.heart-valve-surgery.com\/heart-surgery-blog\/2015\/11\/03\/timing-mitral-valve-repair\/\">Check out the Cleveland Clinic Heart Valve Microsite!<\/a><\/li>\n<li><a href=\"https:\/\/www.heart-valve-surgery.com\/heart-surgery-blog\/2022\/10\/01\/dr-gillinov-patients-meet\/\">Heart Valve Patients Celebrate Their Fixed Hearts, Dr. Gillinov &amp; Our Community<\/a><\/li>\n<\/ul>\n<p>Keep on tickin!<br \/>\nAdam<\/p>\n<p>P.S. For the deaf and hard of hearing members of our community, I have provided a written transcript of this interview below.<\/p>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":2,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"cms.php","meta":{"_acf_changed":false,"footnotes":""},"categories":[10],"class_list":["post-3962","page","type-page","status-publish","hentry","category-heart-valve-replacement"],"acf":[],"aioseo_notices":[],"_links":{"self":[{"href":"https:\/\/www.heart-valve-surgery.com\/learning\/wp-json\/wp\/v2\/pages\/3962","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.heart-valve-surgery.com\/learning\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.heart-valve-surgery.com\/learning\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.heart-valve-surgery.com\/learning\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.heart-valve-surgery.com\/learning\/wp-json\/wp\/v2\/comments?post=3962"}],"version-history":[{"count":19,"href":"https:\/\/www.heart-valve-surgery.com\/learning\/wp-json\/wp\/v2\/pages\/3962\/revisions"}],"predecessor-version":[{"id":5835,"href":"https:\/\/www.heart-valve-surgery.com\/learning\/wp-json\/wp\/v2\/pages\/3962\/revisions\/5835"}],"wp:attachment":[{"href":"https:\/\/www.heart-valve-surgery.com\/learning\/wp-json\/wp\/v2\/media?parent=3962"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.heart-valve-surgery.com\/learning\/wp-json\/wp\/v2\/categories?post=3962"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}