Frequently asked questions

• Which type of heart valve should I decide on?

There are basically two different types of heart valves: biological and mechanical prostheses. Both types have advantages and disadvantages. The biological heart valves do not require special medications to be taken but have only limited durability (about 15 to 25 years according to the patient’s age at the time of the operation). Mechanical heart valves can basically last a lifetime but necessitate lifelong uninterrupted use of medications to thin the blood (warfarin). There is no right or wrong choice of heart valve. You should discuss with your doctor personally which heart valve should ultimately be inserted.

• Can I have keyhole surgery?

If only a single heart valve has to be repaired or replaced, keyhole surgery is possible in most cases. If more than one heart valve is affected or bypass grafts are required in addition, the chest usually has to be opened fully.

• Can I have catheter-assisted heart valve insertion?

This question must be decided individually. Since an ordinary heart valve operation involves little risk and the long-term results are also good while similar data are not so far available for catheter-assisted heart valves, the catheter-assisted heart valve is currently inserted only when a regular operation involves a high risk. This is often the case, for instance, over the age of 80 years. However, the decision must be discussed with the patient in each individual case.

• I have a mechanical heart valve. May I stop the anticoagulation?

No! If you have a mechanical heart valve, warfarin must not be stopped. If you have to undergo surgery or cannot take warfarin for other reasons, you can be switched to heparin instead. However, unfractionated heparin must be used; this is given continuously through a vein. Switching to low-molecular heparin is not permitted; this is given as an injection once or twice a day.

• I have a mechanical heart valve. May I have an MRI scan?

The answer is yes for most patients. All of the currently employed artificial heart valves are made mainly of carbon. Carbon is not magnetic and can therefore be examined in a magnetic field without problems. You will find a list of "antimagnetic" artificial heart valves here (see page 6).

• What must I be careful about after valve surgery?

Every heart valve is a foreign body. Foreign bodies can become colonised by bacteria. For this reason, you should visit your family doctor whenever you get an infection and you may be prescribed an antibiotic. You should also take an antibiotic whenever you have dental procedures (known as antibiotic prophylaxis).