Marc Gerdisch: Mechanical valves require anticoagulation (blood thinners) with warfarin (also known as Coumadin) because the surfaces of the valve are more thrombogenic. Why do mechanical valve patients need to be on blood thinners?ĭr. Patients who need a heart valve replacement in whom oral anticoagulation is already needed for other medical conditionsģ.Young patients with small aortic root not otherwise amenable to an aortic root enlargement procedure in whom a future valve-in-valve TAVR procedure would be ill-advised (size less than 23 mm).Younger patients undergoing complex redo operations where another operation may be of prohibitive risk.Patients with significant longevity potential (i.e.Patients that are medically appropriate to take oral anticoagulation (warfarin).Vinay Badhwar: The evidence is clear to guide these decisions specific to mechanical valve replacement selection: Is there a specific type of patient that might select a mechanical heart valve replacement over a tissue valve?ĭr. At a high level, mechanical valves have superior durability to biological valves made from porcine (pig) or bovine (cow) tissue.Ģ. It remains the most appropriate option for many patients. Vinay Badhwar: Mechanical valves remain a standard and life-saving therapy for thousands of patients. Combining accelerated deterioration of the tissue valve with the likelihood of being alive longer creates a recipe for valve dysfunction and the need to re-replace the valve.ĭr. Furthermore, our bodies have a natural tendency to deposit calcium on sites found on the surface of glutaraldehyde treated tissue (glutaraldehyde is used to toughen the animal tissue). Young people have an active immune system that can attack the foreign tissue of a bioprosthetic valve, resulting in more rapid deterioration than would occur in someone older. Marc Gerdisch: Bioprosthetic valves, on the other hand, are vulnerable to a person’s immune response and begin to interact the moment they are implanted. Mechanical valves do not deteriorate and tend to last a lifetime.ĭr. Marc Gerdisch: When a valve cannot be repaired, whether aortic or mitral, younger patients experience a survival advantage from mechanical valve implantation, over tissue valves (bioprosthetic valves). What are the advantages of a mechanical valve replacement compared to a biological valve replacement?ĭr. Marc Gerdisch – Chief of Cardiovascular and Thoracic Surgery at Franciscan Health in Indianapolis, Indiana.ġ. Murray Professor and Chair, Department of Cardiovascular and Thoracic Surgery, West Virginia University and Chair of the WVU Heart and Vascular Institute. Specific to mechanical heart valve replacements… I often receive patient questions about the valve durability, the use of blood thinners and home INR testing services.ĭuring the COVID-19 pandemic, the importance of answering these questions has become even more critical as home INR test services can provide mechanical valve patients a convenient way to “socially distance” and minimize the risk of coronavirus infection.įor this reason, I reached out to two heart valve specialists to provide you with eleven important facts about mechanical valves, blood thinners and home INR testing during the pandemic. Needless to say, this is a very important and personal choice that can require lengthy consideration specific to the patient’s age and lifestyle. When a heart valve cannot be repaired, patients are typically presented with the choice of a mechanical or a tissue valve replacement.
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