ASK THE DOCTOR: Will there ever be an aspirin-only option for people with mechanical heart valves?

ASK THE DOCTOR

Will there ever be an aspirin-only option for people with mechanical heart valves?

Q. Sometime soon I will need to have my aortic valve replaced. I like the fact that mechanical valves last longer than biological valves, but I don't like the fact that they require you to take the blood thinner Coumadin to prevent blood clots. I have heard that one of the new mechanical valves won't require Coumadin, just aspirin. Is that so?

A. An artificial aortic valve that combines the durability of a mechanical valve with the anti-clotting surface of a bioprosthetic valve would be an important advance. The chance of it happening in the near future is slim.

As you point out, there are two models of artifical aortic valves. Biological valves come from pigs, cows, or donated human hearts. There's usually no need for long-term warfarin (Coumadin) with these because blood clots generally don't form on their surfaces. But they do tend to wear out and need replacement after 10–15 years. Mechanical valves are made of plastic, polyester fiber, or metal. They may last 30 years or more, but they also tend to generate small blood clots that can cause strokes. Warfarin helps prevent such clots.

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