Watch: in my words
Mechanical or tissue valve — how I help patients choose
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Mechanical or tissue?
Mechanical valve
- Designed to last a lifetime
- Requires a blood thinner for life, with routine blood tests to check the dose
Tissue valve
- No lifelong blood thinner required
- Wears out over time — upwards of 15 years in most patients
- If it fails, a valve-in-valve procedure may avoid a second open operation
The right choice depends on your age, your other health problems, whether you can safely take a blood thinner, and how you feel about a possible future procedure. We decide it together.
Sources for this section: Northwestern Medicine — Mitral valve repair or replacement
Common questions
When does a mitral valve need replacing instead of repair?
When the valve is too damaged to repair — for example from heavy calcium, rheumatic disease or infection. I repair whenever a durable repair is possible.
Source: Northwestern Medicine — Mitral valve repair or replacement
Will I need blood thinners for life?
With a mechanical valve, yes, along with regular blood tests. With a tissue valve, no lifelong anticoagulant is required.
Source: Northwestern Medicine — Mitral valve repair or replacement
How long will a new valve last, and what if it wears out?
Mechanical valves are designed to last a lifetime. Tissue valves last upwards of 15 years in most patients, and Duke Health notes up to 20. When a tissue valve wears out, a new valve can often be placed inside it through a catheter. More on valve-in-valve.
Source: Northwestern Medicine — Mitral valve repair or replacement · Duke Health — Ask these questions before mitral valve surgery
Can my valve be fixed through a catheter instead?
For some patients at high surgical risk, a clip delivered through a vein can reduce the leak. More on edge-to-edge repair.
Source: Duke Health — Ask these questions before mitral valve surgery
What will my recovery involve?
Return to daily activities takes about eight to 12 weeks after open-chest surgery, and about four weeks after minimally invasive surgery.
Source: Duke Health — Ask these questions before mitral valve surgery
When can I drive, lift and go back to work?
General guidance from the American Heart Association after heart surgery: no driving for six weeks (riding as a passenger is fine — stop to walk every two hours), no lifting, pushing or pulling more than 10 pounds for six weeks, and light work in about six to 12 weeks. Sex can usually resume once you feel comfortable, often two to four weeks after leaving the hospital.
When I close your breastbone with rigid plates, I release you from sternal precautions at 6 weeks. Your own plan depends on your operation, so we go over it before you leave.
Source: American Heart Association — How can I recover from heart surgery?
