2nd OHS in 3 years for AVR scheduled for 3/31/15

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LynnS

Member
Joined
Jan 31, 2011
Messages
5
Location
Virginia
Well here I go again. OHS surgery for AVR scheduled at Univ. of VA 3/31/15. My Medtronics bioprosthesis (pig) aortic valve is calcified after less than 3 years (I was 56 when replaced). I originally was operated on for aortic regurgitation, now its calcified and stenotic. The gradient across the valve is 65. I understand that that number is bad (determined from my echo in Jan). I originally chose a biosprosthesis because I had 2 episodes of bleeding into my abdominal wall when on coumadin (for atrial fib) ( or Lovenox) and in the throws of bad asthma. I also need my left coronary artery bypassed in the region of former myocardial bridging that was not operated on the first time.
This time thinking hard on a mechanical (On-X my surgeon suggested). I sure don't want to go for #3 OHS and I am still "young" for the bioprosthetic valve. I definitely bruised much more on the coumadin before, not looking forward to that. I am sure I was not well regulated...will want to do home monitoring of my INRs. What is the best machine?
Thanks for the help and moral support!
LynnS
 
Geezuz Lyn I am so sorry to hear this

I wish you all the best with the surgery

I am using the Coaguchek XS and am very happy with it

Pleas email me ifyou want someone to listen and bounce ideas off

Hot mail and my username
 
Hi Lynn,

I posted a very similar topic not too long ago. I am sorry for your news, but really can relate to you!

My "spared" aortic valve gave out around 4 years and was just replaced. My surgeon and I also chose an On-X aortic valve. I am 4 weeks since my second surgery (I'm 34) and feeling pretty good.

Your INR may be managed at a lower level for an On-X valve than it was for A-Fib, and may not have the same unwanted complications you had before.

Good luck!
 
I'm sorry to hear this also.I thought the newer generations of tissue valves supposedly had some sort of anti calcification treatment?
 
Gosh, Lynn - Didn't they offer you the extended warranty on the pig valve? Unfortunately, none of us know if we will be the one whose tissue valve lasts 5 or 25 years. I'm sorry to hear that you got the short one.

I think you're making a good decision. I know that if I was faced with the same issue, that's what I would do. At least this time you know the drill.

We're all here wishing you well, and wishing you a fast, smooth road to healing again.
 
LynnS;n854390 said:
...will want to do home monitoring of my INRs. What is the best machine?
Thanks for the help and moral support!
LynnS

I have used the CoaguchekXS for a year with good results. It is the same meter that my doc uses in his INR lab and I periodically check my meter against his to validate readings. The other popular meter is the INRatio2 which I used prior to my current meter. I was satisfied with that meter, but due to a strip safety and strip availability problem I became uncomfortable. Home meter use has become very popular and is generally covered by health insurance. I am on Medicare which covers my cost on an 80/20 split (about $5/test). I test weekly thru a program administered by Coaguchek Patient Services in Indiapolis IN (1-800-428-4674) with very good results.
 
I also use the CoagucheckXS. Fine machine, but they are distributed by Allere in this country. They are a hard company to deal with. Make sure you keep good records of your interactions with them and order your supplies well in advance.
 
tom in MO;n854417 said:
I also use the CoagucheckXS. Fine machine, but they are distributed by Allere in this country.

Tom, I agree about Alere being a "pain" to deal with. I dealt with them in the past and agree that the service was very poor. If you are in a "program" you might call the number
(800-428-4674) . It is a Roche Subsidiary and the service is extremely accurate and prompt. If you are not in a program you should be able to buy supplies from them for prices similar to Alere.
 
Dick

I buy mine online from medical suppliers. I did a quick Google and prices are about the same as I pay for cash here in Oz . I pay about $140 for 24 test strips delivered. That's about $5.8 a test
 
Aw, Lynn, I'm sorry to hear this. It sounds like you're in a good place regarding your decision and I think you're making the right choice (although I'm sure you don't know whether to laugh, scream, or cry or maybe do all 3).

I don't have any experience or advice to give regarding INR testing (I have a homograft). I just want to wish you well. Good luck and keep us posted!
 
Thanks Dick. I got off the Allere train because my insurance company dropped them. However, the new provider is just a pass through for Allere...isn't that sweet. Since technically they gave me the monitor for free and just charge me for the strips, I can get them anywhere. However, after I meet my yearly deductible (which I'd do anyway for other reasons) it's a little cheaper to use the "preferred provider."
 
thank you all for all of your replies!if I was going mechanical I would definitely do self-monitoring. Well I went to the surgeons office thursday and he said he would use a tissue valve for himself. He is relatively young and athletic.he suggested I talk to my medical cardiologist which I did. That cardiologist strongly recommended I not get a mechanical valve because of my prior 2 life-threatening bleeding episodes in my abdomunal wall when I had severe coughing from asthma and was on coumadin. He discussed using the Ross procedure but I understand that is not as much recommended in adults. So I am probably back to a tissue valve which I will know for sure come Monday. I have one more talk with the surgeon at that time.the choices he mention were the magna ease and St Judes Trifecta valve. his preferences the magna ease given its long-standing track record. He said the Saint Judes trifecta valve also seems to be quite good although again not as long a track record.so many decisions! Thanks again for all of your help!
 
Hi Lynn so sorry to hear about problem. Reading all your story I would have edged towards mech but listen carefully to your cardio and surgeon there are the experts here. IMO they would have the greatest influence on my decision
 
Sorry to hear of your need for second OHS.
I just passed my second anniversary with my ON-X valve.
I home test with the CoagucheckXS. meter.
My INR is stable in my range of 2.0 to 2.5.

Makes sense to stay with a tissue valve due to your bleeding incidents.

Best of Luck on Tuesday!
 
Last edited:
Hi Lynn

LynnS;n854866 said:
.. That cardiologist strongly recommended I not get a mechanical valve because of my prior 2 life-threatening bleeding episodes in my abdomunal wall when I had severe coughing from asthma and was on coumadin.

that sounds like sound reasoning to me ... there are a number of health reasons to beware of being on warfarin and that sounds like it would be a risky combination.

I wish you all the best in making your choices. I wish I could say something more helpful.
 
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