Artificial valves should last a lifetime

Dear Dr. Roach: How long do artificial heart valves last?

K.R.

Answer: There are two main replacements for a heart valve: mechanical and bioprosthetic. A mechanical valve, also called artificial, is man-made of durable materials, and the bioprosthetic is typically constructed of animal tissue.

Mechanical valves generally last longer than bioprosthetic valves. The durability of bioprosthetic valves depends on age. For patients in their 20s, a bioprosthetic aortic valve has a 50% chance of failure at 15 years, while in a 70-yearold, less than 10% of aortic valves will fail during the same time.

Mechanical valves are expected to last a person’s lifetime, although there have been models of mechanical valves that have developed failures of different components and had to be recalled. Since the mortality rate of the surgery to replace an artificial valve overall is somewhere between 7% and 14%, this presents a major problem.

Dear Dr. Roach: I’m a 70-year-old male who fully recovered from a comparatively mild case of shingles 10 years ago. Once I was symptom free, I went ahead and got the early shingles vaccine (Zostavax). I’m now considering the Shingrix vaccine. Do you think it’s warranted in my case? I’m a little wary of possible reactions. I had a triple bypass five years ago and take atorvastatin and metoprolol once a day but am otherwise in very good health.

K.B.

Answer: I do still recommend the new shingles shot, Shingrix, to people who have already had shingles. Although the risk of getting shingles is lower if you have already had it, and lower still if you had the original Zostavax, the risk of a reaction is generally less bad than the risk of developing shingles.

Reactions to Shingrix can be unpleasant. Fever, fatigue, feeling bad and a sore arm for a day are two are common. However, shingles and its complication, postherpetic neuralgia, are so bad that in my opinion the benefits outweigh the side effects.