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Heart Valve replacement
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Heart Valve replacement

I am currently on a waiting list for Valve replacement on the Aorta as i have what is known as a reguritation of the aorta. I have been given two options a metal valve which i would have to take medication called Warfarin for the rest of my life. Or i could have a pigs valve fitted which i would have to have replaced every 15-17 years.  Please could someone help me with the decision of which one to have,  i dont like the idear of the medication but is this a wise move thanks!!
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Avatar_f_tn
only you can make this decision..I went thru the same doubt that you are, but between taking the medication and having other surgery in 15 years I chose to take the medication..It's been 4 months that I have the metalic valve and It's kind of bothering since yoou do hear the valve as your heart beats(like a watch sound) and you have to take the warfarin every single day, and go over regular blood works, no alcohol, no vitamin K (which is found in green vegetables and fruits) You should do a little research yourself and see which one is best for you..
good luck!!!
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Avatar_n_tn
I'm sorry that I can't comment on the types of valves but I have been on Warfarin for the past 2 years and can tell you that it isn't bad.  It's not that you can't eat green's, it's that you need to keep a pretty regular diet of these things so that your Warfarin level doesn't fluctuate.  If you eat greens three times this week, you want to eat greans three times next week so that your level of Warfarin reads about the same and it stable.

I would think that your decision is a pretty tough one, but with some research and questions, I'm sure you'll make the right choice.

My prayers are with you.
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Avatar_n_tn
I am a 53 year old male who just had his mitral valve replaced (post-op day 9!).  I too had to tell the surgeon which type of valve I wanted if he could not repair my valve.  The previous poster is right, the decision is entirely up to you.  However, here are some of the reasons I chose a mechanical valve.  

A tissue mitral valve wears out faster than an aortic valve, and faster for younger people than older folks.  I would have needed to replace a tissue valve in about 10 years (and perhaps two more times if I stuck to tissue valves).  My surgeon felt that the risk of re-operation was greater than the risk from taking warfarin forever.  I have heard from people who have taken warfarin for 30+ years without difficulty.  My surgeon said that taking warfarin increases the chance of a "bleed" by about 1% per year.  After much intermet research, I decided the warfarin would be better than one or more additional open-heart surgeries.  Here is a good link to someone else's comments who faced this decision:
http://www.teamt.us/Mechanical_Vs_Tissue_Valves.htm

My new mechanical valve is working just fine.  I can hear it tick when all is quiet - especially at night.  The sound doesn't bother me at all.  I'm thankful for a new lease on life!  I also wanted to mention that one of the doctors told me that there will likely be alternatives to warfarin in 5 to 10 years.  The same goes for heart surgeries (ie: new minimally invasive techniques).  Changes in future technology may be a factor in your decision.  

Do a lot of internet research to help you with your decision.  Whatever you decide, I wish you the best!  
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Avatar_m_tn
Dont be discouraged.
    I am now in  China,for the last two and a half years,after receiving the main Valve.
I did not get the Mechancial valve. I received the Pigs Valve,and have had no problems.
I take only two medicines,and I am not under doctors care.I get the raw throat from time
to time when I get over-tired,so I just stop,and catch my breath,and take a nap.
   Please do not give it too much thought.My surgeons did not say that I would need
any other valve after fifteen years or more.They said I should last at least twenty or more if I watch my diet.
   I am yet overweight,alot,but am working on lowering it.
   :Let me know how you do.After my surgery,I left the hospital within six days.
    wgang
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Avatar_m_tn
Oldham, I forgot to mention.  I had my operation at 64 years old and two and a half
weeks later was on a Jet flying to China,and to my wife.

     Wgang
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Avatar_f_tn
Hi,

I had a mechanical aortic valve fitted 14 years ago and everything is okay.  As long as you look after yourself generally, don't drink alcohol or drink it to excess if you do drink it at all, you should have no problems with your warfarin...go for your regular blood tests and take the required amount of warfarin daily and all should be well and good.

I was told at 32 that it was better for me to have the mechanical valve as I would likely need to replace tissue valves every 8-10 years, which didn't appeal to me at all..your heart surgeon may have an opinion on what is best for you with regard to your age/circumstances..Good Luck.
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Avatar_f_tn
Your age makes a huge difference in the type of valve you should consider.  In younger people, the number of possible re-ops tends to argue for a mechanical valve, and in elderly people, the better tissue valves can outlive the recipient.  I have had both a pig valve and a mechanical valve.  I am now in my 6th year with the mech valve and on warfarin.  It is definitely NOT true that you have to avoid green vegetables and other foods that have vitamin K.  What you do have to do is eat approximately the same amount of such foods over the course of about a one to two-week period as you do in the next one to two-week period.  If you just eat what you like, you will tend to do that naturally.  It's not hard.  Also, avoid binge drinking, as mentioned above.  I chose the mech valve when my pig valve had to be replaced, because I did not want to have a third OHS.  

With respect to tissue valves, there are now some valves that in research studies have better longevity than the porcine (pig) valves.   One is the Edwards Perimount, which is made from bovine (cow) pericardial tissue.  Also, Medtronics makes a valve -- I can't remember the name of the model -- that is made of a combination of bovine and porcine tissue, and it also lasted a very long time in their studies, longer than the earlier porcine-only valves.  

With respect to mech valves, there now is one called On-X that is being studied to see if patients might be able to use aspirin as their only anticoagulant.  The clinical trials are not complete on that, but it looks promising.  The valve is so well designed that a lot of patients in Africa who were implanted with On-X valves and went back to their remote rural villages and never took warfarin are still doing fine.   The studies now going on in the US are more controlled, of course.  The drawbacks to the On-X are:  A lot of surgeons are not familiar with it, and surgeons understandably like to keep using the type of valve with which they have had success.  It is supposedly harder to implant, it does not fit in all patients, and it does not come with the option of an integrated aortic graft for patients who need replacement of their ascending aorta.

At this time, I have a St. Jude Masters series aortic valve with attached dacron graft.  This make and model of valve has been in use for over 30 years in the US market and has a great track record.  I am happy with it.  There are some things I do not like about being on warfarin, but I have no real dietary restrictions or activity restrictions.  I can eat what I want and do what I want.  I certainly do not regret the decision to get my mech valve.  I came close to dying in my second OHS, and I feel that whatever risks are associated with warfarin are less than the risk of a third valve replacement.

Good luck with your decision.  Whatever valve you get, it will be better than the valve you have.
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