REPLACEMENT VALVE TYPES — WHAT’S THE DIFFERENCE?

Being told you or a loved one need a new heart valve can be overwhelming on it’s own, but it can be even more so when trying to decide which valve type to choose. The choice you make can have an impact on your quality of life as well as the possibility of having another procedure down the line.

The American Heart Association describes the ideal valve replacement as “offering 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.’ The ideal replacement valve also offers long-term durability without significantly increasing the risk of dangerous blood clots or bleeds.”

Read on to learn about the two main types of replacement valves, biological and mechanical.

Biological Valves

Biological valves, sometimes called tissue or bioprosthetic valves, are made of pig tissue (porcine), cow tissue (bovine) or human tissue (allografts or homografts). The most commonly used are porcine and bovine. Biological valves may have some artificial parts to give the valve support and to make placement easier.

Candidates for biological valves have typically been older patients. This is because these types of valves “wear out” and have a limited life span. Should a younger patient have a biological valve implanted, the chances of having to have a second procedure to replace it are high.

The main advantage of a biological valve is that you will likely not need to be on blood-thinner medication to sustain the valve. Your doctor may recommend you take a daily aspirin.

The main disadvantage of a biological valve is that they are not considered as durable as mechanical valves. Historically, biologic valves usually needed to be re-replaced after around 10 years,

Mechanical Valves

Biological valves, sometimes called tissue or bioprosthetic valves, are made of pig tissue (porcine), cow tissue (bovine) or human tissue (allografts or homografts). The most commonly used are porcine and bovine. Biological valves may have some artificial parts to give the valve support and to make placement easier.

Candidates for biological valves have typically been older patients. This is because these types of valves “wear out” and have a limited life span. Should a younger patient have a biological valve implanted, the chances of having to have a second procedure to replace it are high.

The main advantage of a biological valve is that you will likely not need to be on blood-thinner medication to sustain the valve. Your doctor may recommend you take a daily aspirin. The main disadvantage of a biological valve is that they are not considered as durable as mechanical valves. Historically, biologic valves usually needed to be re-replaced after around 10 years.

Mechanical valves are designed to work just like your natural valve and are made of carbon or metal. They are made to last a lifetime and considered very durable. They are well-tolerated by the body but do require the patient to take a blood-thinning medication for life. This is to due to the artificial materials that make up the valve. According to Cleveland Clinic, blood-thinners are medications (such as warfarin or Coumadin) that delay the clotting action of the blood. They help prevent clots from forming on the replaced valve, which can cause a heart attack or stroke. If you take Coumadin, you will need to have regular blood tests to see how well you are responding to the medication and if you need a change in dose.

The main advantage of mechanical valves is that they are designed to last a lifetime, so the chances of having to have another procedure to replaces it are small. The main disadvantage of mechanical valves is having to take medication for life, and the additional risk of bleeding due to the blood thinner medication. Additionally, some patients with a mechanical valve replacement can hear the valve make a clicking noise at times. This can be off-putting for some.

Summary: Factors to Consider

  • Age – Age plays a big role in determining which valve is right for you. Typically, biological valves are used on older patients, as they tend to wear out more quickly. Mechanical valves can be used at any age but are more prevalent among younger patients.
  • Lifestyle/Risk Profile – Quality of life is an important consideration when deciding which valve replacement option is best for you. Mechanical valves require the use of blood thinners, which carry their own risks. And the idea of being on medication for a lifetime is unappealing to some. Oftentimes people who need a valve replaced have other issues that require the use of medication, so this may not be deal breaker.
  • Which Valve Is Being Replaced – The same study from Stanford showed there were differences in outcomes for mechanical valve replacement based on which valve was being replaced. For patients undergoing mitral valve replacement, a mechanical valve is actually beneficial until the age of 70, but for patients undergoing aortic valve replacement, the benefit of mechanical valves ceased after the age of 55.

While educating yourself on your procedure and the valve replacement options available to you is an important part of the process, every person’s situation is unique. Be sure to talk with your doctor to determine what’s best for you.

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This educational blog was provided by Boston Scientific.