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PIG OR MECHANICAL VALVE?
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PIG OR MECHANICAL VALVE?

My 15 yr old son is scheduled for open heart surgery in 4 weeks. If his valve can be repared, it will be. If  it can't, it will be replaced. My son is very active and plays a lot of sports.
I can see him in college, not taking his coumadin, playing sports, and drinking like most kids. I'm afraid of mechanical valve for him for these reasons.
I have 2 questions.
Would a pigs valve be better for my son than a mechanical one if a repair is not possible?
How long does a repair last?
Thank You

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16 Comments Post a Comment
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367994_tn?1304957193
The usual recommendation for a younger person is the mechanical valve. Requires coumadin for the life ot the valve, and there is a clicking sound that may or may not be somewhat annoying.

A pig or bovine valve lasts for about 10 years...the mechanical much longer and possible for the life of the recipient.
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Avatar_n_tn
My father had a pig valve put in at the Mayo clinic in Rochester, MI almost to date 4 years ago. The pig valve quit working properly and we are currently back at the clinic to have a mechanical valve put in. My dad is 62 years old and open heart surgery is major for anybody. I would never recommend a pig valve to anyone. Dads is a mosaic Pig valve.
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690060_tn?1247845341
fwiw, there are new oral anticoagulant drugs on the way to replace coumadin, maybe in a few years
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Avatar_n_tn
Hi there,

Another thought to keep in mind is that every time you redo an open heart surgery it is more problematic. I had an aortic valve repair at 19.  When the valve was replaced at 42 the surgeon had a tough time because of scar tissue from the first operation.  Now I may be looking at my third OHS because of an ascending aortic aneurysm and it will be quite risky because of the scar tissue.

At his age, even if the pig valve lasts 20 years he might need several redos. I've had my mechanical and been on coumadin for 10 years now without a problem.  The question of whether or not you can drink while on coumadin is debatable - patients are told not to, but some drink moderately without any problem.  

I'm not an athletic teenage boy but frankly, I'd go with the mechanical and keep the number of redo operations down.  You will, however, have to drill into his head the importance of taking his coumadin at roughly the same time every day and getting his blood tested when told. Those are vitally important.

As mentioned, I had my first surgery at 19 so I can relate to what you're going through. The good news is that at such a young age he should bounce back quickly. Best of luck to you and your son.  


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Avatar_n_tn
In October 2008, my son had a aortic mechanical valve put in at age 31years. (born with a heart murmur)  He is not atheletic but has a very demanding job in the commercial diving business which keeps him strong. The surgery went well, 4th day he went home. He is now on coumadin and other pills ( 5 pills)  He sets an alarm on his phone, that he carries with him for business, for 9pm to take his coumadin. The only thing I am concerned about is when he is away on jobs, sometimes for weeks, divers like to have beer sometimes in the evening. We mention not to have more than two but sometimes it exceeds that when he is away. Worry yes, a lot . Thats one down side of coumadin.  He has choices though, and I hope he makes the right one. For the sake of his wife,daughter, 2 years and a girl to be born in Dec 2009.
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Avatar_n_tn
My father  was in is late 30's when he had a pig valve replacement ( don't know the name of the brand) , but it lasted 30 years ( yes) without coumadin.  I guess people have different experiences, but generally saying, if you can avoid the Coumadin and considering your son is only 15, I would ask a doctor if this may make him a good candidate for pig valve replacement, if they  cannot repair his original valve.

From our experiences, my father and his cardiologist admits that this drug has too many side effects and reduced his quality of life.  This did not show up until about 9 years into taking this drug. ie. falling and internal bleed causing sub dermal hemotoma.  Hopefully they come out with a better one.
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Avatar_m_tn
I too had my aortic valve replaced at age 31.
I was a drinker and a drug addict up until 18 months ago.
I am now 49 years old and thank God I am still (ticking).
My protime/inr is always changing still after not drinking
and drugging. All I can say is when my levels are real high'
I do like Popeye,(where's me spinich).
I did that once or twice when the cut that was added to the drugs sent my levels skyrocketing.
The alcohol wears off alot sooner, Although I don't recomend either.
The Human body can take alot of abuse.
I hope this will bring some peace to your worries as I no I have put my loved ones thru hell with no conern for myself or the outcome of my actions.
And Oh did I metion I have no HEALTHCARE
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Avatar_f_tn
I can't comment on the valve replacement, however, There is a possibilty that contact sports may be out of the question if he is on blood thinners; you need to ask his doctor about that.
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Avatar_n_tn
I had a mechical valve replacement in 2005, which were suppose to last for a lifetime. However, in July of last year, my valve became closed with scar tissue and a blood clot, I died on the way to the hospital. The team of 4 heart surgeons, brought revived me, yet they did not want to operate on me at the time. My heart were so week, they're only optiion were to send me home after my 2 week stay. But I had to give myself 2 injections of blood thinner for 2 weeks straight. Then I had surgery again. This time the heart surgeon replaced the mechcial valve with a pig valve. Yet, after this second surgery, it left me not being able to work. Both surgeries are extremely hard and took long recoveries, especially for me. I were only 42 in 2005...
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976897_tn?1379171202
I don't really think there is any other answer than mechanical valve. To go through traumatic surgery every few years in your life (risk) compared to one operation is an obvious to me. If in a few years new medication is released to replace coumadin, then great. If in a few years new mechanical valves are released which are much superior, then great again. Until then, I would choose the mechanical for my kids every time.
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Avatar_m_tn
I am 19 year old gal who had open-heart surgery to replace my aortic valve with a porcine (pig) valve when I was 17. I  am to get another valve replacement this summer for my mitral valve with another porcine valve. Choosing the type of valve I wanted was an intense decision.  With your son, I would stay away from mechanical valves for now and save it for the next go 'round considering he plays a lot of sports and probably won't stop playing after having his surgery.  In five years when I get my next valve replacement, I will be receiving two mechanical valves.  Be sure to talk to your Cardiac Surgeons and Cardiologists though.  They will let you know what is best in their opinion based on the experience that their other patients have had.

Hope this helps :)  you're son will be fine.  Advice from the experienced though: LISTEN TO YOUR SURGEONS ADVICE.  
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Avatar_f_tn
Thank you for your input, Roxy.  It's so good to get first-hand info.

I'm an older broad with stable but  mild to moderate leakage of the aortic valve.  I will probably live to my mid eighties, and the question is, "If the valve needs replacement, which one to choose?"   Given that my lifespan includes only about twelve years of additional time on this earth, I'd go for a tissue valve, the reason being that I'm hyper-aware of my heartbeats, and I have a LOT of ectopic beats.  The more fragile but more fragile natural valve would be my choice:  I'd be driven even nuttier by a heartbeat I could hear with every stroke!

But if I were younger and not neurotic (fat chance!), I'd probably go for a mechanical valve, just because they are longer-lasting.  For those who are hyper-aware--well, that's the kind of situation that requires serious thought, if it's not an emergency situation.
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329165_tn?1412685860
Hi there,

I had a mitral valve repair done at age 32 and now have an annulusplasty ring and Surgeon cut away bad segments.  ButI opted for a mechanical valve on standby if the repair did not work.

I was very blessed and fortunate that I could get away with a repair as I don't have to be on lifelong medication like Warfarin, INR checks, etc.  but if I had to choose between mechanical and cow's/pigs valve, I would choose mechanical again as I did not think a guaranteed re-operation every 10 years was an option.

These days INR home-testers, etc. are really good tools and I have a friend with the mechanical valve and you can hardly hear the tick and she got use to it.
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Avatar_f_tn
I think the answer does depend a lot on one's age.  The conventional wisdom is tissue for those over 70, mechanical for those under 50, and take your chances for those in between.  There are some really good tissue valves out now, such as the Edwards Perimount, that are expected to last up to 20 years in older people.  Another advantage of that particular valve is that is is designed to serves as the platform for a cath-deployed replacement valve when it wears out.  There seems to be a trend, in recent years, for surgeons to be willing -- or even to encourage -- the use of tissue valves in quite young people.  But I'm not sorry I got my mech valve (at age 50).  Valve noise was never a big issue for me, but it turned out that I rarely hear the valve.  Coumadin is an annoyance, but it's not the end of the world.  Another valve surgery would be my third, and I just didn't want to go there.  For me, trying to avoid another OHS trumps everything else.  
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