Q. Which valve would be best for my mitral stenosis, biological or mechanical?

Answered by Dr. Sagar Ramesh Makode and medically reviewed by Dr. Nithila A

 

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Hello doctor,

My mother is 59-years-old and has mitral stenosis. CMV was done 35 years back. Now recently she had a heartbeat of 150 and atrial flutter, and she was on Acitrom previously. She has undergone DC cardioversion shock. Now latest ECG shows atrial ectopic and her heart rate is 70 to 80. Can she undergo operation soon? If yes, which valve would be best for her biological or mechanical? Which is the best and latest generation biological valve in the world market?


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Dr. Sagar Ramesh Makode
MBBS., MD, GENERAL MEDICINE ., DM, CARDIOLOGY(SENIOR RESIDENT
Cardiology, General Medicine, Internal Medicine

Hello,

Welcome to icliniq.com.

Yes, she is now a candidate for mitral valve replacement. However, you should make a note that valve replacement is not a complete solution. Firstly, at this age, a mechanical valve is better considering the durability of the valve. Bileaflet valve is the preferred one. Next, she has to be on regular blood thinners. Otherwise, there is a risk of valve dysfunction which may lead to a repeat surgery if blood is not adequately thinned.

Also, this heartbeat problem may not go even after valve replacement and has to be controlled on medicines. Even now she should be on beta blockers like Metoprolol, then Diltiazem to keep heart rate controlled, which are quite effective. I hope this helps you and get back if you have any doubts.

 

Thank you doctor,

Some CTVS surgeon previously advised the biological valve. He told that although it is said mechanical valve lasts longer, in practice, it is seen that these valves show lots of complications and patients even die due to that. So he told biological valve is better. Is it true?

 

Dr. Sagar Ramesh Makode
MBBS., MD, GENERAL MEDICINE ., DM, CARDIOLOGY(SENIOR RESIDENT
Cardiology, General Medicine, Internal Medicine

Hello,

Welcome back to icliniq.com.

The durability of the bioprosthetic valve is less and may need repeat surgery after 10 to 12 years. So, in our case, we prefer mechanical valve before 65 years of age. So, you need to understand the pros and cons of both. Also, if she has some bleeding risk or tendencies, then she will need a bioprosthetic valve. Otherwise healthy individuals of this age, who can take regular medicines and do the routine test, the mechanical valve has a slight upper hand.

 
 
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