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Heart Valve Problems: Should I Choose a Mechanical Valve or Tissue Valve to Replace My Heart Valve?
You may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them.
Heart Valve Problems: Should I Choose a Mechanical Valve or Tissue Valve to Replace My Heart Valve?
Get the facts
Your options
- Get a mechanical replacement valve.
- Get a tissue replacement valve.
Key points to remember
- There are two main differences between mechanical and tissue
valves. One is how long they last. The other is the risk of blood clots. A
mechanical valve will last 20 to 30 years. A tissue valve will last about 8 to
15 years. But the risk of blood clotting is higher with a mechanical valve.
Blood clots can cause a
heart attack or a
stroke.
- If you are 60 or younger, a mechanical valve may be your best
choice. That's because you are young enough that you probably would live longer
than a tissue valve would last. A mechanical valve also may work better for you
because tissue valves can become hardened, or calcified, in people age 60 or
younger.
- If you choose a mechanical valve, you will have to take a
blood-thinning medicine (anticoagulant) every day for as long as
you have the valve. This will lower your risk of blood clots. If you choose a
tissue valve, you will need to take blood thinners for only a few months after
surgery.
- Women who may want to become pregnant and who are
considering valve replacement surgery may want to consider a tissue valve.
Mechanical valves require long-term use of anticoagulants, which may be harmful
to a developing fetus.
- A mechanical valve may be your best choice if you are already
taking blood thinners for another health problem.
FAQs
Heart valve problems that might need a valve replaced include:
- Aortic valve regurgitation.
- Aortic valve stenosis.
- Mitral valve regurgitation.
- Mitral valve stenosis.
Aortic valve regurgitation happens when your aortic valve does not close properly. This lets blood leak backward into your heart. When this happens, your heart has to work harder than it should.
You may need your aortic valve replaced to avoid damage to the heart and to keep enough blood flowing to the body.
Aortic valve
stenosis is a narrowing of the
aortic valve. The aortic valve allows blood to flow from the heart's lower left
chamber (ventricle) into the
aorta and to the body. Stenosis prevents the valve
from opening properly, forcing the heart to work harder to pump blood through
the valve. This causes pressure to build up in the left ventricle and thickens
the heart muscle.
You will likely need your aortic valve replaced if you start to have symptoms. Surgery to replace the aortic valve is the
best treatment for most people.
Mitral valve regurgitation means that your heart's mitral valve is not closing tightly. This lets blood leak backward into your heart. When that happens, your heart may have to work harder than it should.
You may need your mitral valve replaced if you get symptoms of heart failure, if the size of your left ventricle
(your heart's main pumping chamber) increases, or if your heart weakens.
Mitral valve
stenosis means that your heart's
mitral valve doesn't open as wide as it should.
You may need your mitral valve replaced if
you have severe symptoms, your valve is very narrow, or you are at risk for
other problems, such as heart failure.
A tissue valve doesn't last as long as a mechanical
valve. But if you get a mechanical valve, you will need to take a
blood-thinning medicine (anticoagulant).
Tissue valves:
- Last 8 to 15 years. If you get a tissue
valve, you may need a second valve replacement later.
- Can fail
because of the same hardening, or calcification, that damaged the original
valve.
- May tear.
Mechanical valves:
- Last 20 to 30 years. You are less likely to
replace a mechanical valve in your lifetime.
- Can break down. But
this is very rare.
- Have a higher risk of causing blood clotting. To
prevent clots, you'll need to take a blood-thinning medicine for as long as you
have the mechanical valve.
Blood-thinning medicines have risks. These medicines can
increase your risk of bleeding. If you get injured while you are taking
blood thinners, you risk bleeding too much. You'll need to avoid activities
that have a high risk for injury, such as skiing or contact sports like
football.
You will need to get blood tests to make sure
you are taking the right amount of blood-thinning medicine. And you'll need to
tell your doctor about any other medicines or vitamins you are taking. These
may interfere with blood thinners.
Because your body can tell that a mechanical valve is not
made of natural tissue, your blood is more likely to clot on the surface of the
valve. The pieces of the valve are also hard, unlike the soft tissue of a
natural valve. These pieces can tear blood cells as they pass through the
valve. This causes blood clots to form.
Your doctor might recommend a mechanical valve if:
- You are already taking blood-thinning medicines for another
health problem.
- You are age 60 or younger.
Your doctor may recommend a tissue valve if:
- You are older than 65.
- You are younger than 60 and have severe lung disease, heart
failure, or
coronary artery disease.
- You have kidney disease.
- You have a life expectancy of less than 10 years.
Compare your options
|
|
|
|
|
What is usually involved?
|
|
|
|
What are the benefits?
|
|
|
|
What are the risks and side effects?
|
|
|
Get a mechanical valve
Get a mechanical valve
- You will stay in the hospital
for 4 to 5 days after surgery. You will have a big scar on your chest from the
incision. It can take 3 to 6 weeks to recover at home.
- You will take blood-thinning medicine for as long as you have the
valve.
- You'll have regular blood tests to make sure that the
blood-thinning medicine is working.
- A mechanical valve lasts 20 to
30 years. You probably will not need another valve replacement in your
lifetime.
- These valves have
a high risk of causing blood clotting. Blood clots can cause a heart attack or
stroke.
- You'll need to take blood-thinning medicine as long as you have
the valve. This medicine raises your risk of bleeding. You'll need to avoid
activities that have a high risk of injury, such as skiing or contact sports.
- Mechanical valves can break down. But this is very rare.
Get a tissue valve
Get a tissue valve
- You will stay in the hospital for
4 to 5 days after surgery. You will have a big scar on your chest from the
incision. It can take 3 to 6 weeks to recover at home. You may need to take 4 to 12 weeks off from work.
- You'll take blood-thinning medicine for a few months after
surgery, then take an aspirin every day after that.
- You won't have to take
blood-thinning medicine for the rest of your life.
- Tissue valves last 8
to 15 years. If you are 60 or younger, you may outlive a tissue valve and need
another.
- Tissue valves can become hardened, or calcified, over
time.
- There is a rare risk of tissue valve failure or infection.
Personal stories
Are you interested in what others decided to do? Many people have faced this decision. These personal stories may help you decide.
I was born
with a bicuspid aortic valve. The valve has two leaflets instead of the three
it's supposed to have. I'm going to have a mechanical valve, mainly because of
my age—I'm only 25, so I know that if I have a tissue valve, I'll have to have
it replaced at least once, and probably twice. My doctor says that tissue
valves also can become hardened in younger people.
When I found
out that I had a narrowed aortic valve, I talked with my doctor about what type
of valve I should have. We agreed that because I'm 72, a tissue valve would be
fine. They last for 10 to 15 years, and sometimes as long as 20. Besides, I
won't have to take anticoagulants every day for the rest of my life.
I take anticoagulants for another heart
condition. My doctor said that because I take this medicine anyway, I should
consider having a mechanical valve because it will last longer than a tissue
valve.
I decided to have a tissue replacement
valve because I have a history of bleeding stomach ulcers. If I get a
mechanical valve, I will need to take anticoagulants every day, and they can
increase the risk of bleeding. So a tissue valve is a better option for me.
What matters most to you?
Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.
Reasons to choose a mechanical valve
Reasons to choose a tissue valve
I am young enough that I would outlive a tissue valve.
I am older than 65, so a tissue valve will probably last the rest of my life.
More important
Equally important
More important
I don't mind taking blood-thinning medicine for the rest of my life.
I don't want to take blood-thinning medicine for the rest of my life.
More important
Equally important
More important
For me, the benefits of a mechanical valve outweigh the risks of blood clotting.
I'm worried about the risks of blood clots with a mechanical valve.
More important
Equally important
More important
I accept the risk of bleeding that comes with taking blood-thinning medicine.
I have concerns about the risk of bleeding that comes with blood-thinning medicine.
More important
Equally important
More important
I'm willing to change the kinds of activities I do to reduce my risk of injury and bleeding.
I'm not willing to change the kinds of activities I do.
More important
Equally important
More important
My other important reasons:
My other important reasons:
More important
Equally important
More important
Where are you leaning now?
Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.
Getting a mechanical valve
Getting a tissue valve
Leaning toward
Undecided
Leaning toward
What else do you need to make your decision?
1.
Which type of valve lasts longer?
2.
Which valve has a higher risk of causing blood clots?
3.
What kind of valve requires you to take blood thinners for the rest of your life?
1.
How sure do you feel right now about your decision?
Not sure at all
Somewhat sure
Very sure
2.
Check what you need to do before you make this decision.
3.
Use the following space to list questions, concerns, and next steps.
Your Summary
Here's a record of your answers. You can use it to talk with your doctor or loved ones about your decision.
Key concepts that you understood
Key concepts that may need review
Credits
| Credits |
Healthwise Staff |
| Primary Medical Reviewer |
Rakesh K. Pai, MD, FACC - Cardiology, Electrophysiology |
| Specialist Medical Reviewer |
Stephen Fort, MD, MRCP, FRCPC - Interventional Cardiology |
You may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them.
Heart Valve Problems: Should I Choose a Mechanical Valve or Tissue Valve to Replace My Heart Valve?
Here's a record of your answers. You can use it to talk with your doctor or loved ones about your decision.
- Get the facts
- Compare your options
- What matters most to you?
- Where are you leaning now?
- What else do you need to make your decision?
1. Get the facts
Your options
- Get a mechanical replacement valve.
- Get a tissue replacement valve.
Key points to remember
- There are two main differences between mechanical and tissue
valves. One is how long they last. The other is the risk of blood clots. A
mechanical valve will last 20 to 30 years. A tissue valve will last about 8 to
15 years. But the risk of blood clotting is higher with a mechanical valve.
Blood clots can cause a
heart attack or a
stroke.
- If you are 60 or younger, a mechanical valve may be your best
choice. That's because you are young enough that you probably would live longer
than a tissue valve would last. A mechanical valve also may work better for you
because tissue valves can become hardened, or calcified, in people age 60 or
younger.
- If you choose a mechanical valve, you will have to take a
blood-thinning medicine (anticoagulant) every day for as long as
you have the valve. This will lower your risk of blood clots. If you choose a
tissue valve, you will need to take blood thinners for only a few months after
surgery.
- Women who may want to become pregnant and who are
considering valve replacement surgery may want to consider a tissue valve.
Mechanical valves require long-term use of anticoagulants, which may be harmful
to a developing fetus.
- A mechanical valve may be your best choice if you are already
taking blood thinners for another health problem.
FAQs
What heart valve problems might need valve replacement surgery?
Heart valve problems that might need a valve replaced include:
- Aortic valve regurgitation.
- Aortic valve stenosis.
- Mitral valve regurgitation.
- Mitral valve stenosis.
What is aortic valve regurgitation?
Aortic valve regurgitation happens when your aortic valve does not close properly. This lets blood leak backward into your heart. When this happens, your heart has to work harder than it should.
You may need your aortic valve replaced to avoid damage to the heart and to keep enough blood flowing to the body.
What is aortic valve stenosis?
Aortic valve
stenosis is a narrowing of the
aortic valve. The aortic valve allows blood to flow from the heart's lower left
chamber (ventricle) into the
aorta and to the body. Stenosis prevents the valve
from opening properly, forcing the heart to work harder to pump blood through
the valve. This causes pressure to build up in the left ventricle and thickens
the heart muscle.
You will likely need your aortic valve replaced if you start to have symptoms. Surgery to replace the aortic valve is the
best treatment for most people.
What is mitral valve regurgitation?
Mitral valve regurgitation means that your heart's mitral valve is not closing tightly. This lets blood leak backward into your heart. When that happens, your heart may have to work harder than it should.
You may need your mitral valve replaced if you get symptoms of heart failure, if the size of your left ventricle
(your heart's main pumping chamber) increases, or if your heart weakens.
What is mitral valve stenosis?
Mitral valve
stenosis means that your heart's
mitral valve doesn't open as wide as it should.
You may need your mitral valve replaced if
you have severe symptoms, your valve is very narrow, or you are at risk for
other problems, such as heart failure.
What are the differences between mechanical and tissue valves?
A tissue valve doesn't last as long as a mechanical
valve. But if you get a mechanical valve, you will need to take a
blood-thinning medicine (anticoagulant).
Tissue valves:
- Last 8 to 15 years. If you get a tissue
valve, you may need a second valve replacement later.
- Can fail
because of the same hardening, or calcification, that damaged the original
valve.
- May tear.
Mechanical valves:
- Last 20 to 30 years. You are less likely to
replace a mechanical valve in your lifetime.
- Can break down. But
this is very rare.
- Have a higher risk of causing blood clotting. To
prevent clots, you'll need to take a blood-thinning medicine for as long as you
have the mechanical valve.
Blood-thinning medicines have risks. These medicines can
increase your risk of bleeding. If you get injured while you are taking
blood thinners, you risk bleeding too much. You'll need to avoid activities
that have a high risk for injury, such as skiing or contact sports like
football.
You will need to get blood tests to make sure
you are taking the right amount of blood-thinning medicine. And you'll need to
tell your doctor about any other medicines or vitamins you are taking. These
may interfere with blood thinners.
Why is blood clotting more likely with a mechanical valve?
Because your body can tell that a mechanical valve is not
made of natural tissue, your blood is more likely to clot on the surface of the
valve. The pieces of the valve are also hard, unlike the soft tissue of a
natural valve. These pieces can tear blood cells as they pass through the
valve. This causes blood clots to form.
Why might your doctor recommend one type of valve over the other?
Your doctor might recommend a mechanical valve if:
- You are already taking blood-thinning medicines for another
health problem.
- You are age 60 or younger.
Your doctor may recommend a tissue valve if:
- You are older than 65.
- You are younger than 60 and have severe lung disease, heart
failure, or
coronary artery disease.
- You have kidney disease.
- You have a life expectancy of less than 10 years.
2. Compare your options
| |
Get a mechanical valve
|
Get a tissue valve
|
| What is usually involved? |
- You will stay in the hospital
for 4 to 5 days after surgery. You will have a big scar on your chest from the
incision. It can take 3 to 6 weeks to recover at home.
- You will take blood-thinning medicine for as long as you have the
valve.
- You'll have regular blood tests to make sure that the
blood-thinning medicine is working.
|
- You will stay in the hospital for
4 to 5 days after surgery. You will have a big scar on your chest from the
incision. It can take 3 to 6 weeks to recover at home. You may need to take 4 to 12 weeks off from work.
- You'll take blood-thinning medicine for a few months after
surgery, then take an aspirin every day after that.
|
| What are the benefits? |
- A mechanical valve lasts 20 to
30 years. You probably will not need another valve replacement in your
lifetime.
|
- You won't have to take
blood-thinning medicine for the rest of your life.
|
| What are the risks and side effects? |
- These valves have
a high risk of causing blood clotting. Blood clots can cause a heart attack or
stroke.
- You'll need to take blood-thinning medicine as long as you have
the valve. This medicine raises your risk of bleeding. You'll need to avoid
activities that have a high risk of injury, such as skiing or contact sports.
- Mechanical valves can break down. But this is very rare.
|
- Tissue valves last 8
to 15 years. If you are 60 or younger, you may outlive a tissue valve and need
another.
- Tissue valves can become hardened, or calcified, over
time.
- There is a rare risk of tissue valve failure or infection.
|
Personal stories
Are you interested in what others decided to do? Many people have faced this decision. These
personal stories
may help you decide.
Personal stories about mechanical and tissue replacement heart valves
These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.
"I was born with a bicuspid aortic valve. The valve has two leaflets instead of the three it's supposed to have. I'm going to have a mechanical valve, mainly because of my age—I'm only 25, so I know that if I have a tissue valve, I'll have to have it replaced at least once, and probably twice. My doctor says that tissue valves also can become hardened in younger people."
"When I found out that I had a narrowed aortic valve, I talked with my doctor about what type of valve I should have. We agreed that because I'm 72, a tissue valve would be fine. They last for 10 to 15 years, and sometimes as long as 20. Besides, I won't have to take anticoagulants every day for the rest of my life."
"I take anticoagulants for another heart condition. My doctor said that because I take this medicine anyway, I should consider having a mechanical valve because it will last longer than a tissue valve."
"I decided to have a tissue replacement valve because I have a history of bleeding stomach ulcers. If I get a mechanical valve, I will need to take anticoagulants every day, and they can increase the risk of bleeding. So a tissue valve is a better option for me."
3. What matters most to you?
Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.
Reasons to choose a mechanical valve
Reasons to choose a tissue valve
I am young enough that I would outlive a tissue valve.
I am older than 65, so a tissue valve will probably last the rest of my life.
More important
Equally important
More important
I don't mind taking blood-thinning medicine for the rest of my life.
I don't want to take blood-thinning medicine for the rest of my life.
More important
Equally important
More important
For me, the benefits of a mechanical valve outweigh the risks of blood clotting.
I'm worried about the risks of blood clots with a mechanical valve.
More important
Equally important
More important
I accept the risk of bleeding that comes with taking blood-thinning medicine.
I have concerns about the risk of bleeding that comes with blood-thinning medicine.
More important
Equally important
More important
I'm willing to change the kinds of activities I do to reduce my risk of injury and bleeding.
I'm not willing to change the kinds of activities I do.
More important
Equally important
More important
My other important reasons:
My other important reasons:
More important
Equally important
More important
4. Where are you leaning now?
Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.
Getting a mechanical valve
Getting a tissue valve
Leaning toward
Undecided
Leaning toward
5. What else do you need to make your decision?
Check the facts
1.
Which type of valve lasts longer?
You are right. A mechanical valve will last 20 to 30 years. A tissue valve will last about 8 to 15 years.
2.
Which valve has a higher risk of causing blood clots?
You are right. The risk of blood clots is higher with a mechanical valve.
3.
What kind of valve requires you to take blood thinners for the rest of your life?
That's right. If you choose a mechanical valve, you will need to take blood thinners for the rest of your life.
Decide what's next
1.
Do you understand the options available to you?
2.
Are you clear about which benefits and side effects matter most to you?
3.
Do you have enough support and advice from others to make a choice?
Certainty
1.
How sure do you feel right now about your decision?
Not sure at all
Somewhat sure
Very sure
2.
Check what you need to do before you make this decision.
3.
Use the following space to list questions, concerns, and next steps.
Credits
| By |
Healthwise Staff |
| Primary Medical Reviewer |
Rakesh K. Pai, MD, FACC - Cardiology, Electrophysiology |
| Specialist Medical Reviewer |
Stephen Fort, MD, MRCP, FRCPC - Interventional Cardiology |
Note: The "printer friendly" document will not contain all the information available in the online document some Information (e.g. cross-references to other topics, definitions or medical illustrations) is only available in the online version.
Last Revised:
May 9, 2012
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