Aorta valve replacement and medication

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Dmcginn

I have just talked to my surgeon and am planning on getting an aorta valve replacement. I am 55 years old. I love the thought of never having to deal with another surgery but hate the thought of having to take the blood thinner every day. I enjoy having beer or wine from time to time but do not want to commit to drinking the same amount every day. Ditto for the vitamin K issues. I eat greens a lot, but not the same amount each time.

For those of you who have had the mechanical valve installed how has the medication effected your life.

What is the life span of a tissue valve, on average for a man my age?

Anybody in my age group gotten the tissue valve? How do you feel about choosing to go with the more temporal valve?
 
Hello. And welcome!:)

Warfarin has not affected my life whatsoever - I eat and drink what I like (I don't binge drink though)
Remember that you dose the diet, not the other way around - you don't let Warfarin dictate what you eat.
Other people will chip in soon with their perspectives I'm sure, but I just wanted to tell you that I have had no problems with Warfarin so far (2 years post op now).

Bridgette:)
 
Welcome to the asylum! If your a little left of center, you should fit in perfectly. :D

I'm mechanical and I too had the fears you have about "Anticoagulants" (Please don't call it a "thinner" as it makes it sound like your blood turns to water and it does not ;) ) and I've found most everything I've heard about it to be myth and nonsense. I eat what I darn well please, drink whatever I feel like drinking and do whatever I feel like doing. It hasn't stopped me from enjoying life.

With that being said, as part of your decision process, please visit Al Lodwicks site at www.warfarinfo.com and read all you can about Coumadin/Warfarin so that you'll know BS when you hear it and see it.

The largest problem facing anyone on Coumadin are the people that manage you. For some reason, the medical community is not up to speed on proper dosing and management of anticoagulation patients. Some of them are living in the dark ages of early history and not up to date. We will always help you with your issues if you choose to go mechanical. Most all of us have experienced this and for the same reasons, most all of us are home testers and some, self dosers like myself. Yes, home testing could be available to you.

As for the tissue valve and how long it will last. Well the jury is out on that one. The newer valves could last 20 years or so, but we haven't yet reached that plateau to give study numbers. Until then, plan on 10 to 15 years with current available information.

There are plenty of people here your age with tissue valves. I'll defer to them to answer the questions that I cannot.

I'm all in favor of anything that is going to keep you from possibly having another surgery again. There are no guarantees, even with mechanical, that you won't, but mechanical would certainly be best choice to avoid any more. This is one surgery that no one should have to go through once much less a few times. Some will tell you it's no big deal. On the other hand, there are many of us that will tell you it is a big deal.

Take the advice we give, analyze it and apply your own judgment. This is one choice you have to make all on your own. None of us can do it for you.
 
What new modern miracles will be around 15-20 yrs from now?
Heart operations will probably be safer and easier...or not!

55 is a tough age.
45 mechanical for sure!
65 tissue for sure!
At 66 I chose moo-cow valve.
Whatever decision you make, stick with it and don't look back.
It will be right for you.

Good luck and happy 2009
 
I had a mechanical (On-X) installed (I'm 61) in June 2007, was on wafarin for the first three months (no side effects, but constant med readjustments to keep the INR level correct), and then was put on Plavix (again, no side effects, and no more INR testing).

I'm part of an FDA study, & was selected for the Plavix group. If you search the forum, you can find threads that pertain to the On-X study.
 
Welcome! (This is longer than I meant it to be, but you asked what people who chose tissue felt.)

I chose tissue at 60, five years shy of the "tissue for sure" age. As the valve selection sticky says much better, there is no perfect choice--you pretty much have to ask yourself which set of inconveniences and uncertainties suits your personality. The factors that influenced me were that I find dealing with medical bureaucracy extremely trying, I seem to grow cysts and polyps (necessitating medical procedures) frequently, and I am sometimes careless of medical regimes.
Still, because of my "youth" and the fact that my family on both sides usually live well into their 80's, I was amazed that my PCP, cardiologist and surgeon all recommended tissue because of long-term coumadin use. I had read enough here to realize that I could mount an argument if I had preferred mechanical, but their advice matched my own inclination.
My impression is that no-one can give you a longevity for a tissue valve because the improved ones only have about a 12-year history. We may get 20 years, but who knows?
My flawed character allows me to just not think about the next surgery until it gets closer--then I'll be a gifted worrier.
There is an odd sort of comfort in the fact that there is no clearcut choice. The choice you make is the best one for you. You won't be able to beat yourself up second-guessing in hindsight.

Best wishes,
Debby
 
Dmcginn said:
I am 55 years old. I love the thought of never having to deal with another surgery but hate the thought of having to take the blood thinner every day. I enjoy having beer or wine from time to time but do not want to commit to drinking the same amount every day. Ditto for the vitamin K issues. I eat greens a lot, but not the same amount each time.

For those of you who have had the mechanical valve installed how has the medication effected your life.
Click to expand...

Warfarin, for me, has not been a difficult drug to manage. That said, it is a drug that requires a dosing regimen and routine INR testing. Alcohol in moderation should cause no problem. Foods hi in vit K are a non-issue. I eat some kind of "greens" most every day. Warfarin does need periodic dosage adjustments due to lifestyle changes, other meds, etc. I agree with others who have said "the real problem lies with the people who manage your dosage". If you are reasonably consistent in your activities and diet, warfarin should cause few problems.

For me, the more important issue would be the possibility, or probability, of future OHS in your seventies.
 
Hi,
At 56 and after a serious discussion with my surgeon (my cardiologist wanted no part in my decision making process), I decided on a piggy valve. My surgeon who is about my age agreed that since I was in that middle of the road whatever I felt comfortable with would be how he would go. A mechanical valve just didn't seem to be what I wanted but the thought of taking anticoagulants never really entered my mind so that had no input on my decision. I just felt in my gut that a biological valve was right for me. I don't worry about a potential future surgery because I might get hit by an asteroid tomorrow so it would be a moot point. Just do your own research and decide on what ever feels right for you and only you, then go that way..
Good Luck to you and I am looking forward to hearing more from you as you progress toward your surgery.:D
 
Welcome to our wonderful community. I hope you will return and stay with us. This is a great place to wait and get support and answers.

I think everything that DebbyA said, above, falls right in line with my thinking. She said it very well!! A few things I can add to that would be that it truly was a gut reaction for me when I learned of the differences between the valves. I vehemently dislike taking drugs and knew that I would be forgetful and disinclined to "managing" my INR level. I know for so many this is a non-issue. I also am very sound sensitive and though most mechanical valvers eventually appreciate the constant ticking inside of them (a reminder of this gift of life) I sensed that it would drive me bonkers.

There are many emotional discussions here about valve choice. Please do a lot of reading. Be clear on the differences and listen to your doctors. My surgeon (who was 52, just like I was) told me my bovine tissue would be the one he would choose. It was very comforting to be on the same page with him. In my case, my heart had experienced no damage, all other valves were looking great and I was a strong candidate for success with the potential second surgery down the road. How does anyone know if they will live long enough for the second surgery? Sure, we all want to live to be 100, but I simply did not see the value in thinking that way. I wanted what appeared to me, to be the simpler choice with the least impact on my current lifestyle.

Good luck. Don't worry. It will become clear to you eventually which choice you should make. You are wise to be asking good questions. You will find your answer.

Best wishes.

Marguerite
 
I had a bovine valve implanted at the age of 53. I had originally planned to have the Ross procedure, hoping for the best of both worlds, but opted to stay closer to home and go tissue instead.
The surgeon felt that the bovine would last approximately 12 years, and I was content with that. If I live long enough to need another replacement, I'll consider what's available at that time. But for now, it's nothing that I think about.
 
Please don't call it a "thinner" as it makes it sound like your blood turns to water and it does not

I am so new to all of this that I couldn't remember the name of the drug. My surgeon said it was a rat poison that acted as a blood thinner. Either way it didn't sound like something I should look forward to ingesting on a daily basis. I just took a gander at Al Lodwicks site and was amazed at the wealth of information...

I think I am responding to Ross but I might be responding to all of you. I am so grateful for the responses to my post. I felt very much alone and vulnerable in this situation. I just got back from the library and didn't find much of anything to aid me in making this decision. Good to see that you all survived and that I don't have to go under the knife in ignorance.
 
I got my St Jude valve eight years ago at age 47. The biggest influence on my decision to go with a mechanical valve was to reduce the possibility of future re-ops. The Coumadin hasn't really had any effect on my activities or lifestyle. I do triathlons and volunteer at Habitat for Humanity on a regular basis. The only real bleeding problem I've had was due to a botched colonoscopy.
I got into the habit of taking my Coumadin at dinnertime every night along with my Centrum Silver. My INR is pretty stable; I normally go in to get it checked every six weeks.
I also am careful about premedicating before any dental procedures - I take Clindamycin because of my allergy to penicillin.
Good luck,
Mark
 
Dmcginn said:
Please don't call it a "thinner" as it makes it sound like your blood turns to water and it does not

I am so new to all of this that I couldn't remember the name of the drug. My surgeon said it was a rat poison that acted as a blood thinner. Either way it didn't sound like something I should look forward to ingesting on a daily basis. I just took a gander at Al Lodwicks site and was amazed at the wealth of information...

I think I am responding to Ross but I might be responding to all of you. I am so grateful for the responses to my post. I felt very much alone and vulnerable in this situation. I just got back from the library and didn't find much of anything to aid me in making this decision. Good to see that you all survived and that I don't have to go under the knife in ignorance.
Click to expand...

It's tought to decide, but once you do, as others have said, don't second guess yourself on your decision and stick with it. Each and everyone have pros and cons. You just have to decide which of the pros and cons you can live with.

Coumadin/Warfarin does not change the thickness of your blood. That is why those of us on it try to correct people calling it a thinner. Yeah I know, doctors and others still refer to it as a thinner because they don't want to take the time to explain how it works, thinking that most people wouldn't have a clue what they're talking about anyway. Rather then correct it, the continue to call it something that it isn't. It merely inhibits the bloods ability to clot by interfering with Vit K uptake in the liver. Now while that sounds scary in itself, a normal unanticoagulated persons blood will begin to clot in 9 to 12 seconds. Someone on ACT will begin to clot in 20 to 35 seconds, depending on their prescribed INR range. It is not that different. As far as taking the drug for years, we have a couple members that have been on it for 40+ years and they'll tell you that they've suffered no issues healthwise from taking the drug. Now if your not compliant in maintaining your INR range, your asking for trouble and will find it. If you invite it, it will come.
 
Hi! At age 44 last year, I chose the Onx valve, like Andrew, and the valve itself is doing great. I was on Coumadin due to a "side" issue of a clot in my right arm, then very early this year entered the same Plavix study that Andrew refers to - my dosage was the 75 mg Plavix and the 81 mg "baby" aspirin. Just at T'giving, however, the aspirin apparently drilled a hole in my stomach, the Plavix, I'm sure, making it all the bigger. :rolleyes:

So - going back on Coumadin as I write this, starting off on a minimal dosage, getting set up with my own machine here at home to monitor it.

I have come to believe I am just 'clottier' than most folks, even though I was tested in prep for the Plavix study for just that, my HYPERcoagulability, I think was the term for it. It didn't show up then, but I had arm "sensations" that were exactly like the awful "cut-off" of last year's clot in my arm, I had those maybe as early as six years ago, now that I know what they are. My surgeon said he thinks I was throwing "mini-" clots.

T'giving, there was a clot in the left ventricle of my heart. Long sob story, lol, to say you make a choice, you take what comes at you and you work with it and if you are still on two feet and mobile and healthy, you just keep thanking your lucky stars. I never had the opportunity to monitor my own INR as I didn't have this particular cardiologist going into surgery, he is very pro-self-maintenance!

I think keeping up with it daily or bi-weekly at home will make a huge difference. :)

Most who get the Onx do beautifully on the Plavix or Plavix and aspirin from what I am hearing. :cool:
 
Valve selection is a tough and personal decision.
You are very fortunate to have found this site.
When I was facing this there were no resources like this site.
I was 58 at that time and my surgeon said I was too young for a tissue valve, so I ended up with my St. Jude and it's been great.
Coumadin is not the monster so many think it is.
With some education of the patient and those managing their ACT, it is no big deal. Understanding lifestyle changes, medications, and so forth make it fairly simple. The only real challenges come when other invasive procedures are neccessary, then it is a bit difficult.
There is nothing wrong with a tissue valve except it's longevity. I personally hope never to go thru another surgery, but there are no guarantees.
What really convinces me is the thought of another surgery when I'm old, not knowing what could be wrong with me at an older age. This could make surgery a very risky thing.
Good luck with whatever you choose, it will be a new beginning for you.
Rich
 
valve type

valve type

I have a tissue valve from a cow and don't have to take blood thinner other than low dose aspirin every day. My surgery was at 60 years old and I am now 62. My doctors have said that type of valve lasts approximately 10-15 years and when it wears out (which signs would be the similar symptoms I had before surgery) then I would just get another replacement.
Viki
 
normal life

normal life

.
i have an on-x mitral valve and live a totally normal life eating and drinking what i like, when i like. home testing my inr levels helps ensure this is a viable lifestyle.

aside from specialists telling me mechanical was my only option because of my comparitive youth, my main concern in selecting a valve was to ensure i had the least possible exposure to a subsequent operations.

actually, the operation was not too bad, but never again thank you!
 
I am in total agreement with Ross' first response which summarized it all, and felt there is nothing to add! Here are my own humble thoughts after my own experience:

Despite my surgeon's agreement that at my age, 57, I would not go wrong with either the tissue or mechanical valves (St. Jude or On-X), I was going crazy inside me comparing the pros and cons of each, researching different sites and surverys...the time spent on research, the tension of the surgery, the fear of the surgery and the pain afterwards, and the uncertainty of the recovery ... all pushed me to the ceiling and I could not see myself going through this again (no matter how fast medicine evolves) neither in 5 years nor in 20 years when I would be 77 and not sure of my health then. So, for me personally, not wishing to deal with this again and hope I won't have to, I opted to go mechanical.

As for anti-coagulant medications ... this was a big worry on my mind and I wished I did not have to deal with it:rolleyes: In reality, it is not that big of a deal. It took two months to stabilize my INR and voila...I have been on the same dose since then. I am a social drinker...I eat greens on and off and no side effects whatsoever. All the worries I had were a wasted time and I wished I had found this wonderful site way before my surgery -- I could have avoided much agone as it would have helped me reach my decision faster.

Please remember we are here to share our experiences and our own personal thoughts which we hope will help you to make your own personal choice.. The final decision should be yours and once you feel it in your heart and your mind approves of it, do not look back again as other said above.

It is tough...good luck and happy New Year:)
 
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