Choosing Your Heart Valve

For patients facing heart valve replacement, there are two choices: tissue, and mechanical with advantages and disadvantages to each. Typically, patients 70 years of age and older are advised that a tissue valve may be their best choice. Those less than 70 years are advised to give serious consideration to the use of a mechanical valve. Your surgeon will explain these risks and benefits to you during your pre-surgical consultation.

Mechanical Valves

Mechanical valves are more durable and rarely need to be replaced a second time. Unfortunately, mechanical valves are more likely to allow blood clots to form on the surface of the valve. These clots could cause stroke or other major problems and so patients are required to take the anticoagulant warfarin, a blood thinner, to prevent the formation of clots. Patients who take warfarin require frequent blood tests to ensure their dosage is correct. These patients are also at greater risk for bleeding if they have an ulcer or are involved in a fall or other trauma. Additionally, these patients have a higher risk of stroke due to bleeding into the brain.

Tissue Valves

Tissue valves (typically harvested from a pig, fashioned from tissue harvested from the sac surrounding the heart of a cow, or harvested from another human) do not require the use of anticoagulants over the long term. Patients are therefore less likely to be at risk for bleeding or stroke, and do not require frequent blood tests. The downside is that the service life of these tissue valves is normally about 15 years. For patient age 70 or younger, this may mean another valve replacement in 15 or so years.