My bovine aortic valve
Posted: Sat Jun 14, 2014 8:04 pm
Yesterday I had lunch at a vegan restaurant with a friend I hadn’t seen in years. Naturally we discussed my new diet. We also talked about my artificial aortic valve. My friend has a friend facing the same operation I had, and she asked if I had any advice to share about types of replacement valves.
When I mentioned that my own valve is constructed from cow parts, she asked if that sat well with me as a vegan. I confessed I hadn’t thought about it before, but that it was an interesting question.
Some background
I won’t bore you with the details. Suffice it to say I was born with a fairly common congenital heart defect that results in premature wear and tear on the aortic valve. When the condition was discovered, I learned that the only treatment was replacing the valve. I was followed carefully for 10 years. It was never a question of if the valve would be replaced, but when. By 2005 I had begun experiencing the classic symptoms of angina, and the test results indicated it was time for the operation.
I had to make the choice between a mechanical and a “biologic” valve. Each has its pluses and minuses.
Mechanical valves are very reliable and last a lifetime. The minor drawback is that they’re noisy—they can keep your bedmate up at night. The major drawback is that they tend to promote blood clots, which can result in a stroke, so you need to be on powerful blood thinners—Coumadin, for example, which is also used as rat poison—for the rest of your life. Since precise dosage is crucial and is affected by what you’ve been eating, you need to get your blood tested monthly to determine your “prothrombin time,” a measure of how long it takes your blood to clot.
Biologic or tissue valves are made wholly or partially from animal parts. They don’t promote clots, so there’s no need for blood thinners. Their downside is that unlike mechanical valves, they don’t last forever and will eventually need to be replaced.
I went with a biologic valve, an engineered marvel made partly of a cow’s pericardium. I wasn’t happy with the prospect of being on Coumadin forever, and I took a gamble that by the time the bovine valve wears out, medical science will have progressed to the point that the replacement can be done percutaneously—i.e., through a vein, without my having to undergo open heart surgery again. The gamble seems to have paid off. There’s no sign yet of deterioration, and cardiac surgeons have already begun replacing heart valves through minimally invasive procedures.
The bottom line is that I’m doing great. My heart functions normally and I have no restrictions on my activities. I’m extraordinarily grateful to the pioneering doctors and surgeons who, in the late ‘50s, had the skill, vision, and chutzpah to say, “We can fix this!” Without my new valve, it’s certain I would have died years ago.
The ethical questions
I’m sorry the cow whose parts contributed to my valve had to die. (Of course, many more cows died to support the meat-eating habits I only recently gave up.) But is using an animal in this way ethically justifiable? Or is it tantamount to using an animal for meat or leather?
If you, as a vegan, were in the position I was in, and you had to choose a replacement valve, would it be a no-brainer for you to choose the mechanical valve, with its downsides, as opposed to one that made use of animal parts?
What if there were no mechanical alternative available, and the only choice to keep you alive required the death of an animal. Would you hesitate at all to have the operation? Would that be selfish and speciesist? Or is it just as much of a no-brainer that your own life is of higher value than that of the cow or pig that will “donate” its parts to you?
Thoughts?
When I mentioned that my own valve is constructed from cow parts, she asked if that sat well with me as a vegan. I confessed I hadn’t thought about it before, but that it was an interesting question.
Some background
I won’t bore you with the details. Suffice it to say I was born with a fairly common congenital heart defect that results in premature wear and tear on the aortic valve. When the condition was discovered, I learned that the only treatment was replacing the valve. I was followed carefully for 10 years. It was never a question of if the valve would be replaced, but when. By 2005 I had begun experiencing the classic symptoms of angina, and the test results indicated it was time for the operation.
I had to make the choice between a mechanical and a “biologic” valve. Each has its pluses and minuses.
Mechanical valves are very reliable and last a lifetime. The minor drawback is that they’re noisy—they can keep your bedmate up at night. The major drawback is that they tend to promote blood clots, which can result in a stroke, so you need to be on powerful blood thinners—Coumadin, for example, which is also used as rat poison—for the rest of your life. Since precise dosage is crucial and is affected by what you’ve been eating, you need to get your blood tested monthly to determine your “prothrombin time,” a measure of how long it takes your blood to clot.
Biologic or tissue valves are made wholly or partially from animal parts. They don’t promote clots, so there’s no need for blood thinners. Their downside is that unlike mechanical valves, they don’t last forever and will eventually need to be replaced.
I went with a biologic valve, an engineered marvel made partly of a cow’s pericardium. I wasn’t happy with the prospect of being on Coumadin forever, and I took a gamble that by the time the bovine valve wears out, medical science will have progressed to the point that the replacement can be done percutaneously—i.e., through a vein, without my having to undergo open heart surgery again. The gamble seems to have paid off. There’s no sign yet of deterioration, and cardiac surgeons have already begun replacing heart valves through minimally invasive procedures.
The bottom line is that I’m doing great. My heart functions normally and I have no restrictions on my activities. I’m extraordinarily grateful to the pioneering doctors and surgeons who, in the late ‘50s, had the skill, vision, and chutzpah to say, “We can fix this!” Without my new valve, it’s certain I would have died years ago.
The ethical questions
I’m sorry the cow whose parts contributed to my valve had to die. (Of course, many more cows died to support the meat-eating habits I only recently gave up.) But is using an animal in this way ethically justifiable? Or is it tantamount to using an animal for meat or leather?
If you, as a vegan, were in the position I was in, and you had to choose a replacement valve, would it be a no-brainer for you to choose the mechanical valve, with its downsides, as opposed to one that made use of animal parts?
What if there were no mechanical alternative available, and the only choice to keep you alive required the death of an animal. Would you hesitate at all to have the operation? Would that be selfish and speciesist? Or is it just as much of a no-brainer that your own life is of higher value than that of the cow or pig that will “donate” its parts to you?
Thoughts?