AVR and increased risk of stroke?

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M

michellep

I have a question...
Does anyone know the risks of stroke for people with tissue valves?
It seems that over the last six weeks I have had an increase of TIAs (curtain over my right eye, numbness in left arm, migraine in the back of my head, double vision-all at different times) I didn't know until yesterday that they were related. I had an echo and everything looks norm but my blood pressure is averaging 130/89.
Anyway, I had a quad aoerta valve with porcine tissue and was looking for some data on risk of stroke with tissue, rather than mechanical valve. I thought I was safe, going with a tissue valve. Anyone?
PS. I'm seeing a neurologist on Monday.
 
Michelle I don't have the numbers, but risks of thromboembolism with a tissue valve are the same as a properly anticoagulated mechanical valve. I'll see if I can find some numbers.

According to the 1998 FDA Objective Performance
Criteria (OPC), the thromboembolism rate for mechanical
valves was 1.8% per pt-yr (22). The mechanical
valve thromboembolism rates ranged from 0.6 to 3.5%
per pt-yr (2-6,10,17-20,22-27,32-34,40,42,43,48), whereas
the rates of thromboembolism for tissue valves
ranged from 0.6 to 3.9% per pt-yr (8,10,11-17,23,48).

http://www.icr-heart.com/journal/maysup2004/12211_Naples_30_r1.pdf
 
michelle

Even people with all of their native valves have stroke risks. You're risk increases only slightly -- I don't know the exact figures -- by having a tissue valve. If you think you are having TIAs or you are throwing yourself off mentally by worrying about a stroke, ask your doctor if you can take two baby aspirin a day. ths should reduce the TIAs and the likelihood of stroke. Unless there are contraindications most people over 50 (regardless of their valve status) take at least one baby aspirin a day to reduce the risk of stroke.

hope your recovery is going awesome otherwise

best

brad
 
Michelle, I don't think your symptoms are related to your tissue valve. I think it is more likely that they are due to "pumphead" i.e. the cardio-pulmonary bypass machine. The theory is the machine allows tiny bits of debris and air bubbles into the small vessels of the brain. Many of us developed these symptoms post op. I know I did. They wanted me to see a neuro-opthamologist and have MRI's and other tests. I elected to just wait it out and gradually all symptoms were gone by six months. This is the usual result. I think you have a good prognosis.
 
Marty,

Your comment is the best ive read in a while!!!!

Michelle,

I had the double vision too just like you, and its scary but every time i got checked they said it wasnt a TIA, my right eye is a bit blurry and my blood pressure is the same as yours.. I still worry sometimes but it hasnt happened in a while and from what i hear it seems to go away and youll be just fine..

Tommy
;)
 
Hi,
I dont know of the risks of stroke post avr. However there are people who have them. There is a thread by arlyss, about valve strands developing on the valve. Not saying that is what you have, but it does happen to some people, and can cause a stroke. Sounds like if they gave you an echo, that could have been rulled out. It sounds like your blood pressure is a little high. Have they put you on any meds?

I have had issues with my eyes since surgery almost two years ago. They didnt go away for me after 6 months. I see "stars" all day, all the time. Some days are worse then others, but for the most part, they are always around.
However, I dont think, or at least with my experience and what I have read, that the "curtain being pulled down", and "one sided dumbness" is a sign of post-op pumphead. Those are both classic symptoms of a stroke or tia. I am glad to hear that you are seeing a neurologist.

Please keep us posted!

Please keep us posted!
 
My cardiologist added a daily aspirin to my meds after I was still having eye symptoms 9 months post surgery. I have a mechanical valve, but symptoms similar to yours. I hope it clears up for you! I'm glad you're seeing a neurologist. :)
 
I believe Arlyss' comment on strands is related to mechanical valves and not tissue valves.

There is a risk of stroke/clot that correlates equally to that of a properly anticoagulated mechanical valve. Depending on what you read - the number is 1-3%. But we never read what the risk of stroke/clot is for the average person. I think we just tend to assume it's 0%, but I'm sure that's not the case.

Michelle - has your episodes been diagnosed as TIA? If not, I'd be more inclinded to think the symptoms were related to something else. Could the symptoms be migraine related? A friend of mine gets horrible migraines that often mimic strokes.

None the less, I'm sure it's very disconcerting for you and I wish you the very best.
 
Pumphead and strokes

Pumphead and strokes

They think pumphead symptoms are due to "strokes" caused by air bubbles and debris lodged in small blood vessels. Time usually takes care of it but not always. Would a baby aspirin daily help? Maybe but wouldn't hurt.
 
Since I'm also on Coumadin, my (conservative) Cardiologist prefers that I take only one enteric (coated) 81 mg aspirin per day. For people not on Coumadin, I 'think' that 160 mg is deemed to be the 'optimum' amount, perhaps 81mg with breakfast and 81 mg with dinner.

Whenever I develop eye or head issues, I CHEW a regular 325 mg aspirin (non-coated) and wait for the symptoms to clear. So far, they usually clear up within about 20 minutes. I've given up going to the ER but probably would do so if my symptoms did NOT clear fairly quickly.

IF you are interested in following suit, I recommend at least discussing your plan with your Cardiologist (and PCP).

FWIW, I've had the Neuro examinations, MRI, CT, etc. and as with everyone else who has been down this road, NOTHING was ever found.


'AL Capshaw'
 
Marty said:
They think pumphead symptoms are due to "strokes" caused by air bubbles and debris lodged in small blood vessels. Time usually takes care of it but not always. Would a baby aspirin daily help? Maybe but wouldn't hurt.
Click to expand...


Interesting... I always thought "Pumphead" was just a term for the foggy, lack of brain power we sometimes have, as a result of the pump. I didn't realize it actually causes real symptoms.
 
Pumphead rehab works

Pumphead rehab works

savysmommy said:
Interesting... I always thought "Pumphead" was just a term for the foggy, lack of brain power we sometimes have, as a result of the pump. I didn't realize it actually causes real symptoms.
Click to expand...

Special MRI techniques a few years ago actually made pictures of the debris and air bubbles in tiny vessels. Many cognitive tests have shown more than half of us lose some smarts and have some symptoms after being on the pump. Tests also show most of us make a full recovery.Rehab after pump time should include mental stimulation and exercises, puzzles, etc.
 
Well, I am being sent for an MRI and an MRA of the brain. During the MRA, die will be injected through an IV and will show all the viens, arteries, etc, showing a clot, if it is there.
I do have a family history of strokes (my 62 yr old mom has dimentia due to a stroke) and 27 yr cousin almost died due to a stroke.
The right eye going blind (like a curtain going down) is the big concern. The other symptoms could be something else. The blindness seems to be a red flag. I am also having trouble typing at this moment. Blood pressure is staying elevated (averaging 130/90 all week) so time to call the cardio. again.
I'm ready to be healthy now. BTW, I am on 325 mg of adult aspirin daily.
 
Michelle...I hope everything turns out to be ok, I'll say a prayer for you :)
 
Tia's

Tia's

Hi Michelle,

I am glad you are seeing a neurologist and having related imaging done. I had AVR on Jan 25th and had a similar visual change in my left eye... Saw a neuro-opthomologist who thought it was very suggestive of micro thrombolic event even though there was no visible clot on eye exam. I was put on 81mg aspirin and had a Trans-esophageal echo done to rule out clot on valve.. (was negative)

Best of luck with the MRI, hoping all is negative and your symptoms subside..

-lea
 
Be aware that the issues you are having are often related to valve issues and are common both before and after valve surgery. They are more apt to be caused by other issues (e.g., the types of issues that cause migraines) than by TIAs. They wax and wane, and usually decline over time.

It's good to have the MR imaging to rule TIAs out, though, if you're having undue trouble with them - especially with your family history.

If you search through past postings, you will find some people who have been through the maze with neurologists, some for years, and most have come up with no diagnosis, or diagnosis of a hazy, insubstantial dysfunction that doesn't have a cure. Of course, there are a couple who did have TIAs. But you're awfully young for that.

I would also consider stress, allergens, glare, positional discomfort (such as long streatches at the PC) and other issues, based on the premise that they are more likely to be akin to migraine issues.

Lasik specialists have equipment that can visualize the depths of the eye, to the extent that they can determiine if there are microembolism remnants there. Note that taking medications more than aspirin on a guess or hunch should be considered very carefully.

I hope your testing turns out well.

Best wishes,
 
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