Personal Factors that Influence Heart Valve Choice

You and your surgeon will review the heart valve choices as well as the following factors when choosing the prosthesis that is best for your valve replacement.

  1. Age › 70: People over 70 years of age have more complications related to use of anticoagulation.15 Therefore, surgeons most often recommend valves that do not require the permanent use of anticoagulant medication (tissue prostheses). However, many people of that age are already taking anticoagulant medication for other reasons such as heart arrhythmias, or irregular beats.15,47 As many as 50% of patients who have opted for tissue valves to avoid anticoagulation require this medication for other non-valve related reasons.47
  2. Young age: Tissue valves have been shown in studies to calcify and fail at a much faster rate in young children and juveniles.65 While it is desirable to have this age group avoid the use of anticoagulant medication, it is undesirable to have several heart operations prior to adulthood just because the valve fails quickly.
  3. Activity level: People who are participating in activities that risk bruising or injury may want to consider the tissue valve option and the possibility of no anticoagulation to prevent excess bleeding if there is an injury. Examples of this would be skydiving, motorcycle or bike riding, contact sports, mountain climbing, etc.
  4. Desire to have children: Women who are childbearing age and anticipate pregnancy after receiving an implant are safer with tissue valve options. There have been successful pregnancies with mechanical valve patients, but pregnancy and birth entail risk of life-threatening consequences for both the mother and unborn child related to anticoagulation.66-68
  5. Major illness: The presence of a major illness such as diabetes or cancer should be discussed thoroughly with your surgeon and other specialists in order to make the correct decision.