9 years since my valve replacement and all is well. Now perhaps an INR dilemma...

[Les Hazelton]

I should be here to give back to this forum from time to time. My surgery was 4-25-2012 for a St Jude size 25 aortic valve with a replacement length of aorta, at the Mayo in Rochester, MN. I "soon" felt at 100% or better and feel great nearly 10 years after! I live 4 hours away from Rochester, so I returned to the care of my local clinic.

I retired 1-1/2 years ago and this forced a provider change. My INR history has always been stable between targeted 2.0-3.0 with regular testing. When Covid reared up I let my testing frequency slide. At the latest visit I was at 2.2. The doc commented "Hmm I see you have the St Jude valve. The best range is usually 2.5-3.5". So I am trying to re-educate myself because this would be an increase. When I am in the high end I do have some bruising, so... wondering where to go for best practice... Ask for a cardiologist at my current provider? Re-establish with Mayo by sending an inquiry?

My best wishes and thanks to all on the forum for the immense value I received during those months..

 

[pellicle]

When Covid reared up I let my testing frequency slide. At the latest visit I was at 2.2. The doc commented "Hmm I see you have the St Jude valve. The best range is usually 2.5-3.5". So I am trying to re-educate myself because this would be an increase.

as I see it your Dr is the one making the mistake. The target is 2.5 with a range of 2~3, there are quite a few studies backing this up. Indeed I was just banging a slightly different beat on this drum yesterday

https://www.valvereplacement.org/th...valve-and-low-dose-aspirin.887842/post-902084
https://www.valvereplacement.org/threads/longevity-and-quality-of-life.887833/post-902043
I would also suggest you fish through my blog on this topic, especially if you want to self manage for instance:

http://cjeastwd.blogspot.com/2014/09/managing-my-inr.html
look for:

Which shows that between 2.0 and 3.5 the number of "events" (you know, bleeds, thrombosis ... the usual stuff) is really low. Either side of that and the numbers step up. This feeds into my strategy, helping me set my bounds. Interestingly my surgeon initially recommended a range of 2.2 ~ 3 ... which sits well with the above findings...​

on that page
Best Wishes

 

[tom in MO]

I should be here to give back to this forum from time to time. My surgery was 4-25-2012 for a St Jude size 25 aortic valve with a replacement length of aorta, at the Mayo in Rochester, MN. I "soon" felt at 100% or better and feel great nearly 10 years after! I live 4 hours away from Rochester, so I returned to the care of my local clinic.

I retired 1-1/2 years ago and this forced a provider change. My INR history has always been stable between targeted 2.0-3.0 with regular testing. When Covid reared up I let my testing frequency slide. At the latest visit I was at 2.2. The doc commented "Hmm I see you have the St Jude valve. The best range is usually 2.5-3.5". So I am trying to re-educate myself because this would be an increase. When I am in the high end I do have some bruising, so... wondering where to go for best practice... Ask for a cardiologist at my current provider? Re-establish with Mayo by sending an inquiry?

My best wishes and thanks to all on the forum for the immense value I received during those months..

I have a 2007 St. Jude in the aortic position. When I got it the surgeon told me the range was 2-3, but I read here that it changed to 2-2.5. I asked my cardio and he said 2-2.5 was the new range; when I questioned the surgeon, he said "believe the cardio."

This has since been verified by other cardiologists. The range for my St. Jude used to be 2-3 but is now 2-2.5. I've gone much lower for surgery without bridging, because, per my cardio, it's a very stable valve and short term drops are not risky.