Ask the doctor: Valve replacement: Mechanical or tissue?

Q. I'm having valve replacement surgery. I understand there are two different types of replacement valves, mechanical or tissue. What are the pros and cons of each?

A. In general, both types of valves work comparably well. Mechanical valves are made from a special type of carbon or titanium and other sturdy materials. They last longer than tissue valves but have a major drawback: blood clots can lodge in the valve flaps or hinges. These clots can prevent the valve from working properly. Or they may break off and travel through the bloodstream, causing a stroke. To avoid this problem, nearly all people who get mechanical heart valves must take anti-clotting medication (usually warfarin) for the rest of their lives. Warfarin increases the risk of bleeding, but careful monitoring limits this danger.

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