Heart valve replacement: Choosing wise

Written by: Mr Vivek Srivastava
Published:
Edited by: Kate Forristal

Heart valve replacement surgery is a crucial step in managing various cardiac conditions. When faced with the decision to undergo this procedure, understanding the available options and considering individual factors becomes paramount. In his latest online article, Mr Vivek Srivastava aims to address common queries regarding prosthetic heart valves, including the factors influencing choice, differences between mechanical and biological valves, considerations for suitability, associated risks, and the comparative advantages and disadvantages of different types of heart valve replacements.

What factors should I consider when choosing a prosthetic valve for my heart surgery?

Selecting the appropriate prosthetic valve involves assessing several factors, including age, lifestyle, medical history, and preferences. Younger patients may opt for mechanical valves due to their longevity, while older individuals might prioritise bioprosthetic valves for reduced reliance on blood-thinning medications. Other considerations include the presence of comorbidities, anticipated longevity, and the need for future surgeries.

 

What are the differences between mechanical and biological heart valve replacements?

Mechanical valves are typically made of durable materials like titanium or carbon, offering longevity but necessitating lifelong anticoagulation therapy to prevent blood clots. In contrast, biological valves are derived from animal or human tissue and may not require lifelong anticoagulation. However, they have a limited lifespan and may require replacement after a certain period, particularly in younger patients.

 

How do I know which type of valve replacement is best suited for my medical condition and lifestyle?

Determining the most suitable valve replacement involves a comprehensive evaluation of medical condition and lifestyle factors. Patients with mechanical valves must adhere strictly to anticoagulation therapy, which may affect activities and dietary choices. Biological valves offer a more flexible lifestyle but may require earlier replacement, particularly in active individuals or those with complex medical histories. Consulting with a multidisciplinary team including cardiologists and cardiac surgeons can provide personalised recommendations.

 

Are there any risks or complications associated with specific types of heart valve prostheses?

Both mechanical and biological valves pose certain risks and complications. Mechanical valves carry a higher risk of thromboembolism and bleeding due to anticoagulation therapy, while biological valves may degenerate over time, leading to structural deterioration or valve dysfunction. Additionally, there are risks associated with the surgical procedure itself, including infection, bleeding, and prosthetic valve failure.

 

Can you explain the advantages and disadvantages of different types of heart valve replacements in terms of durability, functionality, and long-term outcomes?

In terms of durability, mechanical valves are known for their longevity and resilience to wear and tear, offering lasting functionality. However, they require lifelong anticoagulation, increasing the risk of bleeding complications. Biological valves, while not requiring lifelong anticoagulation, have a limited lifespan and may necessitate repeat surgeries. The choice between these options involves weighing the trade-offs between durability, medication requirements, and long-term outcomes.

 

Mr Vivek Srivastava is an esteemed cardiothoracic surgeon. You can schedule an appointment with Mr Srivastava on his Top Doctors profile.

By Mr Vivek Srivastava
Cardiothoracic surgery

Mr Vivek Srivastava is a highly accomplished and well-regarded consultant cardiac surgeon who specialises in coronary artery bypass surgery, aortic valve replacement, mitral valve surgery, especially mitral valve repairminimally invasive mitral surgery, tricuspid valve repair, multi-valve surgery and atrial fibrillation surgery

Mr. Srivastava is based at the John Radcliffe Hospital, part of Oxford University Hospitals, Oxford. He deals with patients referred from a number of hospitals spread across a wide area of the UK, including the John Radcliffe Hospital, Oxford (Oxfordshire); Great Western Hospital, Swindon (Wiltshire); Milton Keynes University Hospital, Milton Keynes (Buckinghamshire); Northampton General Hospital, Northampton (Northamptonshire); Wycombe Hospital, High Wycombe (Buckinghamshire), Jersey General Hospital, Jersey and Kettering General Hospital, Kettering (Northamptonshire).

Mr. Srivastava can offer face-to-face appointments at various locations as well as e-Consultations with prior arrangement. 

Mr Srivastava has over twenty years of medical experience having completed his first medical qualification in 1999 with MBBS from Gandhi Medical College in Bhopal, India. He has over fifteen years of experience in cardiac surgery with training in India and U.K. and also at the renowned Cleveland Clinic in US where he gained specialist experience in mitral valve surgery and minimally invasive and robotic cardiac surgery. He has published a number of peer-reviewed articles on a range of topics related to surgical conditions of the heart and heart surgery. He is a member of the Society for Cardiothoracic Surgery in GB and Ireland and Fellow of the Royal College of Surgeons of Edinburgh and Indian Association of Cardiothoracic Surgeons. He takes an active interest and contributes to these professional societies via formal and informal roles.

Apart from being a clinician focused on patients’ best interests, Mr Srivastava also takes keen interest in surgical training and education. He is also interested in general management and has recently completed an MBA at the Oxford Brookes University to further his knowledge.  

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