HomeAnswersCardiologyopen heart surgeryWhich valve is suitable for open heart surgery, mechanical or tissue valve?

Kindly advise on the valve placement for open heart surgery.

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The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

Medically reviewed by

Dr. Vinodhini J.

Published At January 8, 2021
Reviewed AtJuly 4, 2023

Patient's Query

Hello doctor,

I am a 46-year-old male. I recently got the echo done and found issues with the aortic valve. The reports show: bicuspid, lateral cusp shows a 6.4 x 6.8 mm structure attached to its free surface? Healed vegetation over lateral aortic cusp, severe eccentric AR, Mild TR, No PAH. Mitral valve - normal. Tricuspid valve - normal. Pulmonary valve - normal. Doctors have recommended open-heart surgery. I am confused with which valve to go with? Should I go with a mechanical valve (metal) or tissue valve? Please advise. I am a vegetarian, non-alcoholic, non-smoker with healthy eating habits. I heard that the metal valve needs lots of attention to avoid clotting. Also, doctors tell us the metal valve if used. I must avoid some green veggies like broccoli, tomatoes, etc. Is this true? I need the correct advice. I also heard that a tissue valve can lead normal life but needs replacement as I am 46 years old. Please advise.

Hello,

Welcome to icliniq.com.

You should go for a mechanical (metal) aortic valve. In patients with age less than 55 years, mechanical valves are recommended. The reason being, the life of the bioprosthetic valve is not great in this age group, and it is bound to degenerate, requiring repeat valve replacement. So mechanical is the preferred one. And it is not easy to undergo repeat valve replacement and is riskier than the first surgery. However, such patients need to remain on a blood thinner called Vitamin K antagonist lifelong, and repeated testing needs to be done (PT INR every monthly to few monthly) to check that blood is adequately thinned or not. Now green leafy vegetables contain vitamin K, which opposes this medicine. One has to restrict their consumption, or one needs to eat them at the same quantity daily (as we can adjust the dose of medication for that particular level of vegetable consumption). So overall, despite these disadvantages, at this age, mechanical (metal) valves are recommended. I hope this helps.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Sagar Ramesh Makode
Dr. Sagar Ramesh Makode

Cardiology

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