Recent content by vitdoc

The company concocted a new variable where they basically added the risk of an embolic process to the risk in bleeding. Using this statistic they found no statistical difference between the different INR regimen. So If you rather have a stroke than a bleed go for the low INR approach. I...

I probably had one of the earliest tissue valves placed in 1977 for aortic stenosis. I was 29. Five and a half years later it failed and I had my first St.Jude. It went from 1983 fo 2006 when I needed an aortic aneurysm repaired at age 58. Could have had a tissue but the surgeon who was very...

About thirty five years ago I had the opportunity to visit Hong Kong where I gave some lectures on certain eye conditions. At that time if you had cataract surgery there you had a choice of three levels of care. You could have the locally made lenses put in with some reusable tubing that was...

Just to add to the emboli discussion. They do occur especially if the INR is too low. In my particular case when I had my temporary visual loss episodes they all happened when I was exercising. So perhaps clots start to form on the valve when the INR is low and maybe they will dislodge with...

I don't think this has been noted as much of an issue. I think if there were "micro emboli" some would not be so micro and there would be focal neurological defects that would be long standing. I doubt there is any issue with showering of emboli leading to alterations in brain function that...

Way back when I was in my thirties after my second surgery for aortic stenosis I used to play full court basketball often for two to three hours. One day after playing I had an appointment for a medical checkup. So I went to the university hospital clinic where the nurse greeted me saying...

I don't think in the cardiology world the precise time to deal with mitral insufficiency is super clear. In general mitral insufficiency tends to be a slow process and often can be monitored for quite a long time. I had long standing insufficiency which sudden markedly deteriorated where I...

As far as I am aware the routine use of aspirin after mechanical valve surgery is not universally suggested. If one wants to run a very low INR as suggested by On-X than aspirin should be added to comply with what was done in On-X's trial. As many have mentioned if stroke is a high priority to...

Yes, narcotics will shut down the Gi tract. That is why they are useful when there is diarrhea. Another option is an enema to help clear things out. Again ask if this is an option. It might normalize things quickly. In the old days the nurses used to say about enemas “high,hot and a helliva...

I have no great information about cause of the pain, however, they might be more generous with the pain meds. The pain may actually be a problem in terms of taking deep breaths which is important to combat atelectasis. (Fluid around the lungs with incomplete lung expansion). They may be...

It is both a curse and a good thing that the medical community is based on making money. Many advances have been made due to the potential enormous profits that may occur with a blockbuster. But at the same time there is hype such as claiming a valve will last 20 years when it hasn't been out...

The two issues you are facing are first the hemodynamic function in a valve that is significantly smaller than the current valve. I can give no advice about that but that question needs to be carefully gone over. Second, what is the life expectancy of you and your potential valve? If you do...

Mitral clips (I have two) are generally used for leaking mitral valves. The leaflets are clipped together to tighten the valve. Valves that are tight already are not candidates for clipping. I had significant mitral insufficiency which was basically cured with two clips placed 7 1/2 yrs ago.

Back in 1977 when I was 29 and very active and before home INR testing I had my aortic valve replaced by a pig derived valve. This was done at one of the major cardiac surgery centers at that time. I had severe stenosis. The surgery was uneventful other than having to be taken back to the OR...

Testimonials are interesting but fairly worthless when it comes to decision making in medicine. We have to fall back on studies and statistics. So yes a tissue valve may last 20 years but it also could last 5. I think an interesting thing is going on in some people’s heads when they consider...