If you need to have a heart valve replacement, you have several choices to consider when discussing your heart valve options with your medical professional. The type of valve and surgical approach have an impact on both your short-term recovery and longer-term quality of life.
Replacement valve’s durability and performance
The ideal replacement valve offers excellent valve function and works in coordination with the entire circulatory system to protect each part from damage. Your medical professional may refer to this as “excellent hemodynamic performance.”
Replacement valve’s risks and medication requirements
The ideal replacement valve also offers long-term durability without significantly increasing the risk of dangerous blood clots or bleeds.
Blood thinner medications can lower your risks of a clot-related stroke or embolism (traveling clot). Clot-risks are higher for people with mechanical valves. On the other hand, blood thinners must be carefully monitored because blood that's too thin will increase the risk of a bleed, which may also become a problem.
Patients and their medical professionals need to choose what is going to be closest to ideal for each patient.
Possible choices include:
Manufactured Mechanical Valve
These valves are made of strong durable materials. They are the most long-lasting type of replacement valve, and most of these manufactured valves will last throughout the remainder of the patients’ lifetime.
Patients who receive a manufactured valve will nearly always require a blood thinning medication throughout the remainder of their lives. The blood thinner will keep clots from forming, which is critical for the person with a mechanical valve because clots can lodge in the valve flaps or hinges and cause a malfunction. Clots can also break off and form into an embolism (traveling clot), which may move through the bloodstream and lodge into a vessel where it may eventually lead to problems like heart attack or stroke.
Donor Valve Implantation
A human donor valve is the least common choice and it’s most often used for someone who is suffering from an illness that affects the valve, such as infective endocarditis. A donor valve can be expected to last 10-20 years.
Tissue Valve (sometimes called ‘bioprosthetic’ valves)
Tissue valves are created from animal donors’ valves or other animal tissue that's strong and flexible. Tissue valves can last 10-20 years, and usually don't require the long-term use of medication. For a young person with a tissue valve replacement, the need for additional surgery or another valve replacement later in life is highly likely.
For each surgery in which the valve must be replaced, careful considerations should be given to durability and medication options and risks. The good news is that a well-performed operation has a high rate of long-term success. If at all possible, consider going to a healthcare facility with a strong valvular surgery specialty and a good track record in valve surgeries.
You have options when choosing a heart valve. Survivor Robert Epps shares the factors that influenced his own heart valve choice: