For those with tissue valves: a question about aspirin.

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valerie415

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Edmonton, Alberta, Canada
Hi fellow tissue valve owners!! I have a bovine valve and am 5 and a half weeks post-op. I called my surgeon today to ask if I could stop the metoprolol and aspirin (as I'd run out of the first prescription of both). The dr. said I could stop the metoprolol if my Family doctor says okay, but that I would need to take my 81mg aspirins one a day "forever".

I was a little downhearted at this news, as forever is a long long time, and I was hopefully thinking I wouldn't have to take anything. Plus I've heard that some docs only prescribe it for a month, others for 3 months. I'm just wondering if it really is necessary to take it forever and if there is a big risk in not taking it.

I'm also wondering if certain herbal supplements could do the trick just as well: I already take Carlson's omega 3 fish oil, and raw garlic, and I would like to resume taking Dan Shen, which I can't take if I'm taking aspirin. I believe all these things do the same as aspirin, but maybe I'm wrong.

Thanks for sharing any wisdom you may have on the topic! I really appreciate it.

--Valerie :)
 
Not a tissue valver, but I can tell you that most everyone is put on an asprin regimen after surgery. It's just added insurance to keep you from forming clots. Don't try to use herbals in place of asprin. It's for your own safety.

With that being said, there is a lot of thinking going on by the physicians. Some feel it's not necessary, but most do. I'm not going to try to second guess them on this one. I know this is confusing/conflicting, but if it helps prevent a clot, I'm all for it.
 
Hi Valerie,
I posted this exact question on one of my threads a while back. You may be interested in seeing the responses.
I am no longer on aspirin as I am in my 40's, at a low risk for coronary artery disease, female, have a tissue valve etc. as explained by my doctor. However, every case is different and there is different rationale for why doctors keep patients on aspirin post-op. It wouldn't hurt asking :). Here's the link to my post. Hope this helps!
http://www.valvereplacement.org/for...tic-Tissue-Valvers-and-Aspirin-Use&highlight=
 
Justin has a bovine valve in his pulmonary conduit and does not take any meds. He took baby aspirin the first month or so. I wonder if the reason your doctor wants you on aspirin forever, has more to do with your age and not your valve, since many docs like people over 50 to be on aspirin to hopefully prevent heart attack/strokes
 
Justin has a bovine valve in his pulmonary conduit and does not take any meds. He took baby aspirin the first month or so. I wonder if the reason your doctor wants you on aspirin forever, has more to do with your age and not your valve, since many docs like people over 50 to be on aspirin to hopefully prevent heart attack/strokes

Yes, Lyn I was thinking the same thing. On my previous thread with the same question, I found the guidelines for the use of ASA for female and males in different age groups used for the prevention of stroke/heart attack.
Here is my post from the previous thread:

"Hi Folks,

I just found this updated article from the Annals of Internal Medicine: So, it looks like it isn't recommended in my age category for the prevention of CAD; however, still wondering if aspirin would be of any benefit from a valve perspective?

http://www.annals.org/content/150/6/396.full
Clinical Guidelines
Aspirin for the Prevention of Cardiovascular Disease: U.S. Preventive Services Task Force Recommendation Statement

From the U.S. Preventive Services Task Force, Agency for Healthcare Research and Quality, Rockville, Maryland.
Next SectionAbstract
Description: Update of the 2002 U.S. Preventive Services Task Force (USPSTF) recommendation about the use of aspirin for the prevention of coronary heart disease.

Methods: Review of the literature since 2002, focusing on new evidence on the benefits and harms of aspirin for the primary prevention of cardiovascular disease, including myocardial infarction and stroke. The new evidence was reviewed and synthesized according to sex.

Recommendations: Encourage men age 45 to 79 years to use aspirin when the potential benefit of a reduction in myocardial infarctions outweighs the potential harm of an increase in gastrointestinal hemorrhage. (A recommendation)

Encourage women age 55 to 79 years to use aspirin when the potential benefit of a reduction in ischemic strokes outweighs the potential harm of an increase in gastrointestinal hemorrhage. (A recommendation)

Evidence is insufficient to assess the balance of benefits and harms of aspirin for cardiovascular disease prevention in men and women 80 years or older. (I statement) Do not encourage aspirin use for cardiovascular disease prevention in women younger than 55 years and in men younger than 45 years. (D recommendation)

The U.S. Preventive Services Task Force (USPSTF) makes recommendations about preventive care services for patients without recognized signs or symptoms of the target condition."
 
Valerie, I am a tissue valver and I take the 81 mg (low-dose) aspirin, and presumably will for the duration. Haven't had any ill effects that I am aware of. Do have to stop it temporarily when having some kind of procedure, such as having a cyst removed from my back a few weeks ago. Just had to stop for a few days.

The 81 mg compares with a regular aspirin, which is 325 mg, if memory serves. So it truly is low dose. I don't discount the possibility that even the low dose may cause problems for some (some are allergic to it, for instance)-- so monitor it. But I think the low dose, when coated for stomach safety, works well for many folks.
 
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Valerie,
I've got a bovine valve, and I'm 5 years out of replacement. I suffered some TIA's before replacement, so I take 325mg of enteric coated aspirin a day. Sometimes I think it's a little much, so I'll skip a few days, but I figure I am on it for life.
My husband has no heart conditions and his family doctor put him on 81mg many years ago. Like Ross says, it's pretty common.
I don't know anything about herbal supplements so can't offer any advice there.
Best wishes,
Mary
 
I have a bovine valve and take aspirin daily. Just about everyone I know over 50 takes a daily 81 mg or 325 mg aspirin every day and will for the rest of their lives.
 
I'm just a little over 3 weeks post-op, had a porcine aortic valve & root replacement. I'm a 47 yr old female and I too will be taking 1 baby aspirin daily for the duration. I was told this before I made my decision to go with a tissue valve.
 
Valerie, My Surgeon & Cardiologist kept me on Metoprolol for six month. I am no longer taking the Beta-blocker but they both advise taking aspirin daily. It seems a very small price to pay. Unless you choose to make your own herbal aspirin from willow bark, I don't know of any non perscription drug that can replace it including herbal supplements all of which are themselves drugs. We like to catorgize things but when you take a compound other than the normal food that you eat, it is a drug.

White Willow Bark Tea

1 four cup pot of hot water, not boiling
4 teaspoons very well chopped up bark
honey or other sweetener

Have the hot water ready and put the willow bark in your favorite tea brewing holder.
A cotton bag or one of those little metal balls with holes in them.
Put the herb brewer into the water.
Wait 15 minutes.

Overview
Willow bark tea is a brew made from the bark of the willow tree. It has an anti-inflammatory effect similar to aspirin, so it is used to relieve minor pain and reduce low-grade fevers. Willow bark's pain relieving effects are not as strong as aspirin's, but the tea is gentler on the stomach than aspirin tablets.

Function
Willow bark contains salicin, which converts to salicylic acid in the body. Salicylic acid is the same compound found in aspirin and other analgesic medications. It acts as an anti-inflammatory which makes it effective against headaches, lower back pain, and the aches associated with rheumatism, bursitis and tendonitis. Willow bark also has anti-oxidant and antiseptic properties that may help it alleviate pain symptoms at lower doses than aspirin.

History
Willow bark and willow bark tea are mentioned in historical texts dating back thousands of years. Hippocrates prescribed willow bark tea to women in childbirth and advised patients to chew the bark to relieve pain and reduce fevers. Ancient Chinese, Egyptian and Assyrian texts mention using willow bark as an anti-inflammatory and antiseptic, and Native Americans drank the tea for similar medicinal purposes. In the 1890s, the Bayer company used salicin from willow bark and other plants to develop the extract later used in aspirin.

Types
Willow bark tea is most commonly made from the dried bark of the white willow tree. Other varieties of willow, such as the purple willow and crack willow have higher amounts of salicin, and some dried willow bark sold in stores contains a mixture of the three varieties of tree. Unlike tablets that contain powdered willow bark, the concentration of salicin in dried willow bark is not always consistent.

Brewing Tea
Willow bark tea is best brewed slowly to extract the maximum amount of salicin. Use about 2 grams of powdered or chipped bark for each cup of tea and steep it for up to eight hours in cold water. Strain the brew before drinking it, and heat it if desired. Each cup of tea should contain 60 to 150 mg of salicin, which is the equivalent to a low dose of aspirin. The brew is quite bitter and can be mixed with sugar, honey or lemon to improve the flavor.

Warnings
People who are allergic to aspirin or who have been advised not to use aspirin should avoid willow bark. This includes people with gout, asthma and gastrointestinal disorders. Pregnant and lactating women should not drink willow bark tea because its effects on the fetus and breast milk are not well known. Willow bark should not be used along with other anti-inflammatory medications. Children under 16 years old should not drink willow bark tea for fevers because of the increased risk of Reye's syndrome associated with aspirin. Like other herbal medications, willow bark and willow bark production are not FDA regulated.
 
I have been taking aspirin since I had my previous tissue pulmonary valve 19 years ago.

Debbie
 
Thanks for all the input. You're right, it must be my age (60). I'll be having my post-op appointment with the surgeon soon and maybe he can explain his logic. I only found out yesterday over the telephone from his secretary that I should take the aspirin forever.

The white willow bark tea sounds interesting....does it have to be a tea, or can you take it in capsules I wonder.
 
Valerie, I have had a tissue valve for 2+ years now. I took my baby aspirin for about the first couple of months. I have problems taking NSAIDS, including aspirin. I e-mailed my cardio and surgeon at the Mayo and told them I was having problems taking them...here was their responses to me:

Although we recommend low dose aspirin to all patients with valve
prostheses, this is not universally recommended in other countries. I
will copy your surgeon to see if he has a recommendation about this. I do
not think you need any replacement/alternative therapy if you do not
tolerate the aspirin.

And from my surgeon:

If there is a problem with aspirin, I would just not take it. There is
no concrete data that it will prolong the life of this valve.

So, I basically have been off aspirin for 2 years. I'm not advocating that you go off of it, just let you know of my experience. If I could tolerate it, I would take it.


Kim
 
The aspirin is an opinion. After three months (six months if some aorta is replaced, too), you're no more likely to have a stroke than anyone your age with the risks you had before surgery. It is fairly common practice that anyone over 50 (or even just everyone with no specific reason not to) who is going to a cardiologist is put on 81 mg aspirin. It's not warranted in all cases, but they like to just hand the assignment out to everyone. Not all do. It would be easy to find a cardiologist who wouldn't mind if you didn't take aspirin, assuming you have no coronary disease.

What is ironic is that these aspirin are all coated, and dissolve in your colon, rather than your stomach. Scottish scientists found that the colon doesn't absorb aspirin as well as the stomach and small intestines, so many people don't absorb the dosage that they took. I take two to get at least 81mg.

What do you think is so unnatural about aspirin? Acetosalycilic acid (aspirin) and its variations occur often in nature (feverfew, willow bark, etc.) and are used by naturopaths all the time.

Best wishes,
 
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And from my surgeon:

If there is a problem with aspirin, I would just not take it. There is
no concrete data that it will prolong the life of this valve.



Kim

This is an interesting comment made by your surgeon Kim. So, what I am hearing is that some surgeons are keeping patients on aspirin as there is some suggestion that it may prolong the life of the tissue valve. I was under the impression the aspririn was to prevent stroke/heart attack. However...if it may possibly prolong the life of the valve, I may just start taking it!! :D

Has anyone else been told this?
 
This is an interesting comment made by your surgeon Kim. So, what I am hearing is that some surgeons are keeping patients on aspirin as there is some suggestion that it may prolong the life of the tissue valve. I was under the impression the aspririn was to prevent stroke/heart attack. However...if it may possibly prolong the life of the valve, I may just start taking it!! :D

Has anyone else been told this?

Honestly, That remark was in response to my questioning him. If I recall, I asked him if me not taking it would have any effect on the valve and that's his response.
 

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