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Mitral valve replacement
I am a 53 year old male.  I have mitral valve prolapse/regurgitation and am about to have my valve repaired (hopefully) or replaced.  If the valve must be replaced, I have to decide whether to opt for a mechanical or tissue valve.  I am familiar with the advantages and disadvantages of each.  Can you tell me how much higher the risk is when having a second valve replacement (as I would likely need one or more replacements with a tissue valve).  Would this risk outweigh the risk of taking coumadin for 30+ years?  Can a tissue valve be replaced with a mechanical valve safely in the second (or third) surgery?  Will advances in technology make it safer/easier for a second valve replacement in 10 or so years?  Will advances in blood thinners make them less risky?  I would appreciate your comments as I am going for the surgery in a week!  Thanks.
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I have taken Coumadin for 29 years after having my Aortic valve replaced at age 20.I have been hospitalized 1 time  about 25 yrs ago for a bleed out at my kidney but I must admit I was not very responsible about my own health care and was taking 10mg daily per doctors instruction. I now take 7.5 mg 3 days a week and 5 mg the other 4.My INR is usually about 1.9,lower than the 2.5-3.5 recommendation but I feel comfortable with it at that level.My opinion is that properly managed Coumadin usage is far less risky than any open heart surgery, although open heart surgery is certainly common and probably very safe.   The opinion seems to be that the tissue valves last 10-15 yrs. Do you really want to have heart surgey again in 10-15 years?
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