One of the questions that I often encounter with patients undergoing valve replacement surgery is “Which valve should I choose?” Because the types of valves in clinical use nowadays are divided into two categories: “mechanical valves” and “biological valves,” both of which have their own advantages and disadvantages and are not perfect, so to help you make a good choice, the following is my personal experience.
First, a comparison of the two types of valves
Biological valves
Mechanical valves
Valve life expectancy
15 years or so
≥40 years
Time to anticoagulation (warfarin)
Short postoperative period (3-6 months)
Lifetime postoperatively (nightly dose)
Number of anticoagulation monitoring (blood draw)
Short postoperative period (3-6 months)
Postoperative lifetime (at least once a month)
Chance of patient bleeding or embolism
Low
High
Recommended for people
Over 65 years of age.
or young women who are planning to become pregnant;
Under 60 years old and not planning to get pregnant
Pregnancy and childbirth
No effect, basically the same as normal people
It is troublesome and highly dangerous and requires frequent examination and treatment at a qualified hospital
What happens when a valve is damaged?
Valve damage begins immediately after surgery, but it is slow, less life-threatening, and can be reoperated at a later date
Valve damage is often instantaneous, mostly life-threatening, and requires immediate reoperation
Second, then are the results of common patient selection in my clinical work for your reference
1.Most young and middle-aged patients under 60 years of age prefer mechanical flaps. Most of the older patients over 65 years old choose biological flap. 60-65 years old patients are the most difficult to decide because this choice is like asking them in judging their life expectancy in general, it is difficult.
2, Some young adult patients under the age of 60, who pursue quality of life and do not want to take daily medications and monthly blood tests, prefer to have another surgery in a decade or so and choose the biologic flap.
3, most women who have not had children, have chosen the biological flap, hoping to replace the mechanical flap when they operate again after having children and the flap is damaged (because the mechanical flap may be damaged in about 40 years, which means that it may need to be operated on again around the age of 60, and not necessarily for life!) The mechanical flap is not necessarily lifelong! Some women who have not had children choose a mechanical flap because they have decided not to have any more children. In fact, mechanical flaps are not absolutely impossible to get pregnant, but you have to pay more money, time, and take greater risks.
4, Most patients with intractable atrial fibrillation choose mechanical valves (because atrial fibrillation itself requires anticoagulation therapy).
5, tricuspid valve replacement because of the current technical factors, doctors generally recommend choosing a biological valve.