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Aortic Valve Replacement Choices

Updated on February 16, 2010

Aortic stenosis is a narrowing of the aortic valve in the heart. If the valve doesn’t open completely, it slows delivery of blood from the heart to the body. The heart then pumps harder, which weakens it and produces symptoms such as shortness of breath, chest pain, fatigue, and fainting.

You don’t have to be a geezer or senior to get aortic stenosis. It can occur in younger people, including children. However, it’s more likely to be found in men than women.

Eventually, a doctor, usually a cardiologist, may suggest replacing the aortic valve. The patient will typically then have two primary options for heart valve replacement – mechanical or tissue valves. A third, less common option is a homograft. The following is a basic explanation of the three. It is not intended as medical advice but can help when talking to a heart doctor.

The Human Heart
The Human Heart

Mechanical heart valve

The first option for a heart valve replacement is a mechanical valve, also known as a “prosthetic” valve. This valve consists of mechanical parts made of metal, carbon, and/or synthetic material.

The advantage of a mechanical valve is its durability. It is designed to last for some 20 to 30 years, meaning more elderly patients will be less likely to need the valve replaced in their lifetimes.

The disadvantage is that because of the artificial material used, blood clotting is a risk. Blood clots can lead to heart attack or stroke. To minimize this risk, people with a mechanical valve will need to use anticoagulant medication (blood thinners) to prevent clots from forming. They will need to take the medication daily for the rest of their lives. People with this type of heart valve must also monitor their blood levels. Monitoring usually means monthly blood testing at the doctor’s office, a lab, or at home using a specialized testing kit.

Additionally, some people report hearing the clicking of their valve as it opens and closes with each heart beat.

Tissue Valve

The second most common valve used in heart valve replacement surgery is the tissue valve. It is also known as a “bioprosthetic” valve.

Tissue valves are made from pig (porcine) or cow (bovine) cardiac tissue. These animals are used because their cardiac tissue functions much like human heart valves. The animal tissue is chemically treated in order to preserve the tissue and help avoid rejection in the human body.

The advantage of tissue heart valves is that people with them usually don’t need to take lifelong anticoagulant medication (blood thinners) as required with mechanical valves.

The disadvantage is that they are not as durable as mechanical valves. This means tissue valves typically last only from 8 to 15 years. At that point, the person will need to have the valve replaced – meaning once again undergoing the risk of heart valve replacement surgery.

Choosing between types of heart valve replacements

For children and adults below the age of 60, mechanical valves may be the right choice because these people are more likely to outlive a tissue valve, which would probably require a second heart valve replacement surgery.

Tissue valves may be the right choice if the person is less likely to outlive their valve or for someone who has risks associated with taking blood thinner medication for long periods of time.

Choosing a mechanical or tissue valve is not a cut and dried decision. The patient should talk to their cardiologist and heart surgeon and do their own research. You can begin with some of the links listed below.

Homograft Valve

A homograft, also called a biologic valve, is an aortic or pulmonic valve from a donated human heart. The heart is removed from a deceased person, preserved, and frozen. Obviously, a homograft depends on the availability of a human donor whose heart has valves of the right size and length for the patient getting the valve. This means its biggest disadvantage is lack of supply.

The operation to put a homograft in is also more complex than standard heart valve replacement surgery.

On the plus side, a homograft is usually very resistant to infection and performs well. It also typically doesn’t require the patient taking blood thinner medication for life.

Homografts are expected to last longer than tissue valves, but because they have only been in use for about 15 years, this is still unknown.

Heart valve surgery summary


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      Billsnotes 5 years ago

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      mitral1 6 years ago

      Good stuff. I dont remember reading such a good article. You should write more!!!

      Heart Valve Repair