> There are quite good reasons to not replace, not least of which is that replacement valves are nowhere as good as your native, particularly if it’s still func

> There are quite good reasons to not replace, not least of which is that replacement valves are nowhere as good as your native, particularly if it’s still functioning. The flow dynamics of newer metallic valves (like the Onyx) are superior in many ways. Not the least of which is consistency and durability, with a reduced risk of aortic dissection. Always go with a metallic. > can be a massive pain and cause other complications. The complications are not from the valve, of course. The complications are from the surgery which can disrupt electrical pathways (scarring of the chambers) with a worst-case pacemaker (additional risks and effects). _AVOIDING THAT RANDOM STRUCTURAL RISK IS THE BREAKTHROUGH_ The blood thinner is a cautionary medication for the newer valves by policy, until there are a few decades of field data. That being said, taking Sodium Warafin can cause common side effects like light sensitivity and chronic constipation. The excessive bleeding is overblown for a standard long cycle INR target of 2-3. When you get over 4 (due to triple doses or some other unusual circumstance), you will start to have bleeds that don't stop easily, in my experience.