Recent content by Astro

Hi Zara, Hope you are going well. Have you decided tissue or mechanical yet? Warfarin is a big challenge with pregnancy. Warfarin creates birth defects so clexane injections are generally required throughout the pregnancy. Full anticoagulation excludes epidurals or spinal options for delivery...

Possible reasons for the valve area to inaccurate (it doesn’t make sense that the valve area would increase with time) 1) valve area error due to mitral valve interference before it was fixed 2) valve area involves making a measurement that has error and then squaring it - so any error is...

Some of you have been having a rough time. All that painful bridging. What would I do? For the first two days take about 150% of my normal dose (if the usual is 6mg, take 9 or 10mg for two days) then check my INR and fine tune from there. It is so much easier when you have the keys for the...

Hi pellicle, Best wishes with your arrhythmia. The scarring from heart surgery can certainly change conduction in the heart leading to arrhythmias. However, arrhythmias are also common in people with structurally normal hearts who have had no heart interventions. The association between AF...

Thanks Chuck C, This is the second randomised controlled trial (RCT) looking at the timing of surgery for severe aortic stenosis. The other one was by Kang: Early Surgery or Conservative Care for Asymptomatic Aortic Stenosis - PubMed Both are small trials so we won't know the definitive...

That is great that both St Jude and ON-X are equally good. No need to worry about what brand was placed in your chest or what brand will be placed in your chest. (Though, might upset some advertisers)

There may be a couple reasons why new mechanical valves are so noisy at first but get better with time: 1) Before the valve replacement, your heart thickens or expands to pump harder to compensate for your tight and/or leaky valve. When the valve is replaced, initially your heart continues to...

Hi Pellicle, Happy New Year to you . 🎄🎅😄 The optimum timing for valve replacement surgery is a complex issue. Surgery has its obvious risks. This needs to balanced against permanent heart scarring from letting a heart start to fail. For aortic stenosis there has been only two randomised...

Thanks ETC908 for your careful summary of this complex topic. I agree that it is choosing between two good options (no surgery is very bad). I feel that Arnold Schwarzenegger is a good example of a Ross procedure. Avoiding warfarin allowed him to continue his action movie career - fantastic...

That’s an interesting idea. Does vitamin K from greens really have a strong effect on INR? The mechanism is plausible because warfarin blocks formation of the active form of vitamin K that is required for blood clotting factors. Just because it is plausible doesn’t mean that it works. Are there...

I agree with Pellicle, I eat a lot of salads and try to be fairly consistent with frequency and amount. My warfarin doses reflect my salad intake, rather than avoiding to salads to protect a warfarin dose.

Hi AI3x, I hope you have managed to get some more sleep last night. I had a similar unpleasant experience trying to grab some sleep. A few points on reflection: 1) I normally sleep on my side. On my side, I don’t snore. However, I think that I snore/airway obstructs when sleeping on my back or...

Hope your consult went well. TAVRs are a game changer. Such a quick recovery compared to the old valve replacements. Best wishes

I have my fingers crossed for you. It is reassuring that the last scan was good. Best wishes

You have a plan. I’m guessing that you also have a date. Best wishes. After some time, you will get back to “normal”. You will hopefully be healthier, fitter and taking things less for granted than if the valve problem didn’t occur.