Rob's Journal

Dan Fouratt  Rob,  I went with the Edwards INSPIRIS RESILIA. There have been several discussions about this valve on the website.  including one about the Billion Cycle test:

https://pubmed.ncbi.nlm.nih.gov/36003435/

I am 63 and had no hesitation on which valve type and then which biological valve.  If I get 15 to 25 years  from that valve and another 10 from a TAVR at that point I am counting on medical to have a better solution in 25 plus years.

All decisions are personal, but the above was mine.  Good luck in your decision journey.

Dan

Teressa Phillips  Hi Rob! Dan makes a great point about the Inspiris Resilia. Any mechanical valve will require Warfarin for the remainder of your life. There are tests currently ongoing with the less dangerous anticoagulants that are promising, but right now it is Warfarin all the way. Some valves like my On-X have a lower INR requirements, but I'll still be taking it the rest of my life. From what I know, your list of sports are some of the ones where they encourage bio valves regardless of age.

Rob G  Thanks for the info Dan. I'll ask my surgeon about it and if it is available as an option. Curious how long ago did you get your valve replaced? 

Rob G  Teressa do you find it to be a hassle taking Warfarin and the ongoing maintenance of checking blood your? Also, curious how noticeable the ticking sound is with your On X and if that bothers you much?

Rose Madura  I chose a tissue valve at age 59. I did not want to be on warfarin (I tend to be a clutz) and this summer I had a bike accident which confirmed my decision.  But is was a hard decision. But I have no regrets. My advice is always to do your due diligence and research. Make a decision and run with it. Don't look back or second guess yourself. It is a decision only you can make. And it is not easy!

Daneen Douglas  Hey there Rob! I’m 52 and will be getting my surgery in about a month and a half from now.  My surgeon says about 50% of surgeons will recommend biologic valve and 50% will recommend mechanical valve.  Yes, we are in that grey area.  It really is a personal choice and depends on your lifestyle.  My surgeon knows very active people who are into competitive sports who have chosen both types of valves and are happy with their choices.

 For me, I am choosing a biologic, most likely Medtronic Freestyle bovine biologic valve, which will replace my root as well as my aortic valve.  It will also accommodate a TAVR down the road. I am also getting my ascending aortic aneurysm replaced.  This valve is often used in combination with this procedure.   My surgeon says they are lasting 19 years so far and may last longer but they are only 19 years old, lol. Also, I’m super clumsy and like to cook.  I cut myself often and like to hike and be active.  For me, I didn’t want to deal with blood thinners, the loud noise of the valve, and inability to get some types of tests, ie; MRI’s, etc.. 

 My mom is living with two mechanical valves and has had many complications.  I do not want to deal with that.  So, for me it was an easy choice.  Good luck with your decision!

Pamela Gregory  Hi Rob. I got my aortic valve replaced with biological valve at 55. They did the aortic root as well to accommodate a larger valve so that I could get TAVR down the road. Also did not want to be on blood thinners.

Tiago Rocha  Hi Rob. Im 47 and replaced my AV last January. Choosed the bio (Resilia Inspiris) after diligently informed myself and in strict coordination with my doctor. All the comments above stress the main points. The best thing is that with both options you will have a solid solution! Take your time, don’t hurry that much and choose the one that make you feel safe (physically and mentally ) and allow you to be confident with your desired lifestyle. Plan thongs with your doctor. I’m also confident that things might evolve in the future. Regards

Dan Fouratt  Rob,  I have shared this a couple of times on this site.  I had and either or decision for treating a brain tumor. Two different approaches each with their pluses and minuses. In my research one doctor told me to "make a decision that is right for me as both decisions are correct so I cannot be wrong.   After the decision was made focus on the execution and DO NOT second guess yourself". As Tiago states both options offer a solid solution, so you too cannot be wrong.  You will make the right decision for yourself.

Teressa Phillips  Hi Rob, I wasn't given much counciling ahead of time about my choice. It was strongly suggested because of my age (50) that I go with a mechanical valve. I didn't even know what brand I was getting until I got my card post surgery. My aortic root was a good fit for a 23mm On-X valve which is an appropriate size for me. I don't have any hobbies that would suggest I needed to go with a tissue valve. I've been joking that I will never be an elder Roller Derby star now.
I take my warfarin at night with my other night medicines. For the first 8 weeks I didn't have any changes. I've had a slight change recently, but that just means a few more checks. Right out of the hospital I was checked every 2-4 days, eventually that went to weeks between checks. Since they made a change I'm back to an every 2 week schedule for a few checks. I just have a lab appointment at my cardiologist's office, so it is easy to schedule first thing in the morning or around lunch time. I've been told once I am stable for 3 months I can get a home testing machine. It is similar to a blood glucose monitor, but requires a bit more blood (still a finger prick). I do not have any food restrictions. They just ask that I eat a fairly consistent amount of high Vit K foods. The philosophy has changed from limiting healthy veggies to managing warfarin dosing. Everything online still has the limiting or eliminating the veggies.
Not everyone hears their mechanical valve clicking. It is more common for women to hear it than men because of our physiology in the neck. I experience my valve clicking in 3 ways. In a quiet room I can hear it in my ear from the vibration, I can hear it externally, and I have a small vibration pop in the back of my throat. I have been shocked at how little it has bothered me. It has not negatively impacted my life at all.
I'm glad you are gathering information to make the best decision for yourself. Good luck with the venture.

Rob G  Thanks so much for all the responses and for sharing of your choices and decision making. I spoke with my surgeon about it today and although he didn't make a recommendation he was definitely building a case for mechanical which is making the decision even harder. He said the complexity of the reoperation is increased quite a bit due to scar tissue etc. Then i speak with someone I know who's mother in law had a car accident 2 years ago and nearly didnt survive because she was on blood thinners. Very confusing since there really is no wrong choice and each comes with its own risks and advantages.