Valve Selection help

[murph341]

Hi everyone, I must start out by saying thank god for this forum! I stumbled across it while doing research. I was born with aortic stenosis, well its now time to replace my avr at 42. I have done allot of research about the advantages and disadvantages of each valve choice (Ross is off the table) but I have some specific questions. I keep reading about people being active with a mechanical valve but I do not play sports, run, weight lift but I do ride and race motorcycles (road not mx). It is not my profession but it is something I am very passionate about! I know head injuries is a big concern while on warfarin, does wearing a full face helmet lower the risk? How about internal injuries, broken bones while on this medication as well? I am not too concerned with the diet aspect and taking a pill a day with the mechanical valve. One thing that does freak me out is the possibility of stoke with a mechanical valve. I have been trying to find the average percentage of strokes directly related to the valve but my search is coming up empty. I know based on the above statements I should get the bio valve but at my age I don't think I want the possibility of another 2-3 surgeries. So to sum it up is there anyone here that is into motorsports that has a mechanical valve? My doctor of course because of my age wants me to get a mechanical valve and believes i should hang up my helmet Thank you for taking the time to read this, I really can't say thanks enough for everyone taking the time to comment on all the post's it’s been really helpful...

 

[clay_from_nj]

I have a mechanical valve, don't race motorcycles, but do sometimes ride VERY fast on the highway. I have always worn a full-face helmet and figure that a really bad head injury would be really bad whether I was on warfarin or not. Do you get injured frequently from racing, or is it just one of those things that might happen someday? If the latter, I would submit that walking down the sidewalk could also get you involved in major injuries; it's all a matter of perspective.

 

[pellicle]

Hi

Hi everyone, I must start out by saying thank god for this forum! I stumbled across it while doing research. I was born with aortic stenosis, well its now time to replace my avr at 42....

Like clay I also ride bikes, but I have not raced since my MX daze as a kid and occasional track days with mates are not quite the same (but I probably see more "offs" there than races. Now on the road I ride this

and a T-Max round town and shopping


I was diagnosed at 5 and I had my first OHS at 9. My surgeon (was not a separate cardiologist back then) regularly had fits about my MX riding but (like my mother) stopped objecting after about 5 years.

My view is this: warfarin alters your clotting, it does not weaken your blood vessels, so to me if it makes one prone to a bleed it strongly indicates vascular disease at some level. Do you "bruise easily" now?

I have personally had offs that have left people shaking their heads at I didn't get a mark, and yet have seen fellas killed in a simple slide (into a pole). The variation "out in the wild" is too complex to calculate, so I would worry more about smoothness and consistency lap to lap than warfarin. Warfarin does not mean y turn to jelly, it just makes a small difference to clotting. Michael Schumacher was not on warfarin ... bad stuff happens randomly.

Did the worry of getting made a paraplegic stop you racing? Didn't think so....

I have a mechanical now and still ride, only death or incapacitation will likely stop me.

Read my comments here too:
http://www.valvereplacement.org/for...ical-VS-HomoGraft-vs-Ross&p=551154#post551154

 

[joanpieroni]

Hi, Does any of you motorcycle riders know how long after AVR surgery I need to wait to go for a casual ride as a passenger? I guess I will have to call the surgeons office. No hurry though spring is certainly taking it's time to warm up here in Western NY. Burrrrrr.

 

[murph341]

Pellicle,
Great choice of words! I do not race anymore but listed it that way because not a lot of people are familiar with track days. I am actually a track day coach

I keep reading don't let warfarin control you, you control it. I guess I'm just over thinking this whole process way too much.
I am so glad you replied to my post. i was getting nervous that no one was in a similar situation! This is something i was thinking ( keep riding) but i needed to hear it from someone else I believe i have come to the conclusion that i will be getting the mechanical valve! Now it's the long wait for surgery which isn't until the end of may.

 

[clay_from_nj]

joanpieroni- My surgeon told me not to drive a car for six weeks after surgery, mainly due to my healing sternum. Absent any other guidelines, I would think that this would probably apply to motorcycling as well, since there isn't much that can happen there that would affect your chest worse than smacking it into a steering wheel.

I have a coworker who, on the way home from a totally different kind of surgery, was in a car accident and broke her (uncut) sternum. Just an interesting related anecdote.

 

[joanpieroni]

driving and riding

driving and riding

I actually had a AVR March 27th but between my ribs not a full sternomony, granted there is a titanium plate attaching my rib back to my chest bone. I was able to drive at 3 weeks.

 

[pellicle]

Hi

I am actually a track day coach

excellent! Always good to see people doing that to help keep the bullet-proof toe-scratchers at it safely!

my hat is off to ya!

sweet looking bike, and a great shot! I'm sure this isn't a 'selfie' ;-)


Best Wishes

 

[pellicle]

Hi

Hi, Does any of you motorcycle riders know how long after AVR surgery I need to wait to go for a casual ride as a passenger?

If you treat it like any other bone breakage ... I'd suggest 8 weeks, but make sure that it has knitted properly (surgeons usually want to test this with some pressure on the bone with their fingers).

I can't recall how soon after AVR I was riding my bike along the highway to work... for sure at 3 months I was back there, but it could have been 2?

I'd say as soon after that when you feel you're good to go, then you'll be good to go

 

[tom in MO]

The risk of using warfarin is easy to calculate, hard to judge.

Most mechanical valve patients have an INR between 2-3, let's say 2.5. This means it takes 2.5 times longer to clot than a "normal" person. For sure your bruises will be larger and your abrasions will take longer to stop bleeding. When it comes to brain damage??? Warfarin could take a moderate brain clot to severe, or take a severe brain clot to death. If you view death as perferable to severe brain damage, your relative risks could cancel out. Most people don't understand why riders take the risk, thus most doctors will tell you to hang up the helmet.

Per stroke, your risk with a mechanical plus anticoagulation is the same as with a tissue valve.

There are no dietary restrications for warfarin. That's the old way of thinking. They dose the diet now.

 

[chaconne]

murph,

I would say, whether you should ride or not depends on how often you expect to fall. In full-contact football, you're always expecting to get hit in the head, and that may be too big a risk being on Warfarin. On the other hand, if you ride motorcycles (or mountain bikes like me) and don't expect to fall on your head often, or ever, then it's less of a risk, and OK to do.

Regarding strokes, I think the statistics can be misleading since they don't individually consider age, overall health and quality of Warfarin management. In other words, the risk of stroke for an otherwise healthy 42 year old, with a mechnaical heart valve who is in range 90% of the time, is much lower than the stated average.