Recent content by Silver Bullet

I was very worried about this as if I can hear my watch or a clock ticking, I can't fall asleep. I never hear my valve (mechanical aortic) unless its quiet and I'm not distracted, so I do hear it when I lie in bed before fallen asleep. Thankfully, it rarely keeps me awake for anymore than a few...

My recollection is that there were 2 OnX clinical trials. One was warfarin vs no warfarin. The no warfarin group received ASA and Plavix and this is the one that required subjects to be ASA sensitive. This study has never been reported to my knowledge. The second study was INR2-3 (plus ASA) vs...

I'm bench pressing 95 lbs 4.5 months after AVR. Feels fine. Remember not to hold your breath while lifting and always breathe!

Get your information from Cardiologists who work in a clinic that specializes in the care of pregnant patients with cardiac disease, not from a forum on the internet. Pregnancy with a mechanical valve can be life threatening. It's a hyper-coagulable state (pregnancy makes blood clots more...

There was a trial with low risk recipients of an On-X valve in the aortic position comparing warfarin to ASA/Plavix, but the trial was stopped. I don't know why. On-X should tell us why it was stopped and should share the available data because the trial did get underway and patients were...

I agree that the PROACT trial didn't concretely prove that an INR goal of 1.5-2.0 is safe and associated with less bleeding even though that one trial showed exactly that. The problem is that it's just one trial that is sponsored by the manufacturer. Nevertheless, the PROACT trial shouldn't be...

I came in at 163 lbs and got home a week later at 153 lbs. Nearly 5 weeks out, I haven't gained any back, and am watching my diet and walking about 5 km every other day.

JulienDu: 1) I agree that there are good reasons to *speculate* that all modern bileaflet mechanical prostheses in the aortic position of low risk patients may do well with an INR range of 1.5-2.0, but until evidence directly testing that hypothesis becomes available for those other valves...

Can you wear something to protect you from getting all those little cuts? I'm not worried about bleeding per se, but if there's bleeding, then blood vessels are being opened, so if I were you, I'd be worried that they could serve as portals of entry for bacteria that could circulate in your...

I was just indicating that the study you provided in no way impacted what I wrote and which you quoted, indicating that there is no direct evidence for any valve other than On-X that a goal INR of 1.5-2.0 is acceptable for low risk patients with AVR.

Bleeding risk is clearly higher when the INR is higher, even within the 2-3.5 range. How you feel about it and how much you beed when you cut yourself is no way to determine whether that's true or not. Only randomized trials can show that and the data there is extremely consistent: bleeding risk...

Pellicle and JulienDu, my comments stand, since they refer to the absence of evidence supporting an INR goal of 1.5-2.0 with mechanical aortic valves other than On-X. Evidence that a range of 1.5-2.5 or 1.8-2.8 is acceptable is not the same as evidence that a goal of 1.5-2.0 is. A goal range of...

Eric, at the age of 39, I certainly agree that a mechanical valve makes the most sense. A Ross procedure also makes sense if you can get a surgeon who is a master at doing it, preferably with published results indicating excellent long term outcome (like Dr. Tirone David) and if your aortic root...

I faced a similar choice at the age of 46. Keep in mind that if a part of your aorta is going to be replaced, redo operations will be more complicated than if you just have a valve replacement that needs to be redone. Plus, at your young age, you may have to face a third surgery if your initial...

I had an echo just before surgery, and the update on my pre-op values is: LVEDd = 67-70 mm (severely dilated) LVESd = 44 mm LVEF 0.60 My post op day 7 values are LVEDd = 57mm (upper normal) LVESd = 46 mm LVEF 0.48 I'll update these in 3-6 months, during which I expect improvement in my LVEF to...