The main advantage of this type of artificial heart valve is its excellent lifetime durability. Theoretically, the valve can last forever. In other words, if you have a mechanical valve, it is unlikely that you will require another surgery on the same valve. Avoiding another operation is very appealing to many, especially those that are young.
However, the major drawback is the need for long-term anticoagulation with a "blood thinner". This medication goes by different names but the most common one is coumadin, which is a potent blood thinner and requires careful monitoring by a physician. Aspirin is also a blood thinner but it is not potent enough for mechanical heart valves. Taking a blood thinner is necessary to prevent the formation of blood clots on the valve. These blood clots can break off and cause a variety of problems such as a stroke and malfunction of the heart valve. As a result, a blood thinner is an absolute requirement after placement of an artificial mechanical valve.
But taking a blood thinner has its own complications. The major problem is a risk of bleeding. Studies have reported that the rate of anticoagulation-related bleeding complications in patients with mechanical valves is as high as 30-40% over 10 years versus 10-20% for patients with tissue valves. A bleeding complication can be minor, such as bleeding from a superficial cut, but it also could be major, such as bleeding in the brain or in the gastrointestinal tract.