Reality Bites. Mitral Valve Replacement.

Sometimes, Reality bites.

I am facing mitral valve replacement plus a bypass of the left anterior decending "WidowMaker" artery.

The senior surgeon who is apparently the one doing the procedure is leaving it up to me whether to do a cow (or pig) valve or a metal valve.

If it is a pig valve, then the expected duty cycle is 10 to 12 years before replacement is required again.

If it's a metal valve it doesn't fail often, however I would have to be on blood thinners for life, with all the resultant complications.

 An argument in favor of the pig valve is that I don't have to add medicines that complicate things, and 10 years from now who knows he might have better technology than we have today. The surgeon was fairly dismissive of the beta developments for putting an implant in without opening the chest; mostly because it's not completely approved and he thinks the technology will get better. Also he pointed out the risk factor is having to have emergency open heart surgery because the implantation fails in some fashion. Also he can't do all of the same trimming of the valve etc.

The disadvantage the blood thinners and a steel or whatever metal valve is among other things that I'm at risk for bleeding which would be uncontrollable if in fact I was in an accident. Kidney, liver or head trauma would result in an unacceptable outcome because they can't stop the blood thinners, and they can't control the bleeding. (As I understand it anyway).

 My good friend went through this with her late husband a couple years ago. Specifically the blood thinners but he also had incipient dementia and some other issues.

I have asked a couple friends, because of their professional expertise, because they usually can think their way out of a paper bag, my friend for her experience; and my sister and partner for obvious self-evident reasons. Among other things my sister was the primary caregiver for my mom and I trust her.

I myself am tempted to go with a pig valve and avoid the blood thinners but that immediately indicates that 10 years from now I will probably have to either have open heart surgery again with higher risk and complications, or they will do some other procedure entirely which may or may not be viable at that point.

My Dad made it to 67 as a smoker; had a heart attack and it took him 6 months to pass at in ICU.  I remember.  Mom made it to 103 and 1/4, and she lived a good life.

Thanks for listening