Dr. Aklog explains the valve options for patients who needs their aortic valve replaced.
So there are really two broad categories of valves that could be used to replace a diseased aortic valve. They are those valves that are made from animal tissue, typically cow tissue or pig tissue, and there are pure mechanical valves that don’t have any animal tissue, that are made out of mechanical parts.
It’s important to understand this distinction because those two broad categories both have significant pros and cons. A valve made out of animal tissue, the primary advantage of that is it does not require typically the patient to be on blood thinners: Coumadin and Warfarin. The primary disadvantage is that these valves can wear out over time, and so if a patient has it for long enough, they might need to have it replaced at some point in the future.
Mechanical valves, on the other hand, require the patient to be on blood thinners for the rest of their lives, and, however, they don’t typically wear out. So the decision with regard to valve choice for a patient undergoing aortic valve replacement generally is based on the patient’s age. So older patients who need aortic valve replacement, typically will get a tissue valve. Younger patients will typically get a mechanical valve. The cut-offs can vary depending on the patient’s interest, but most people over 65 to 70 will get a tissue valve; most patients under 50 will get a mechanical valve.
In the 50 to 65 range, there, it’s a bit of a gray area, and the final decision really needs to be made between the patient and the surgeon, depending on the patient’s preference, whether they are open to the idea of being on blood thinners for the rest of their life to avoid another operation, or if they’re really adamant against being on blood thinners, or if they have a reason not to be on blood thinners, in which case they might accept the possibility of having another valve operation at some point down the future, usually 12-15 plus years.
About Dr. Aklog, M.D.:
Dr. Lishan Aklog is the current Director and Chief of Cardiovascular Surgery at The Heart and Lung Institute of St. Joseph’s Hospital and Medical Center in Phoenix, Arizona and Director of EmpowHer's Medical Advisory Board. Specializing in adult cardiac care, he graduated from Harvard College followed by Harvard Medical School. Dr. Aklog was a cardiothoracic resident at Brigham and Women’s/Boston Children’s Hospital, an Associate Chief of Cardiac Surgery at Mount Sinai Medical Center in New York, and completed international fellowships in London, England and Paris, France.
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