Long term implications of your valve choice when you get other heath issues

[yotphix]

This topic has been nicely discussed but I'd like to ad one thought before it goes away. I've perused the web myself to learn more about this topic, and found numerous references, from sources including medical universities, which suggest that warfarin leads to osteoporosis. The problem with the sources is that they can't help but have bad information since warfarin ACT patients have been told for so long and by so many to avoid eating K rich foods, and especially to avoid K supplements. Perhaps not coincidentally, some of the references also referred to Warfarin as a 'blood thinner', and indication of how much we ought to value them as sources of information.
For Example:
http://umm.edu/health/medical/altmed/supplement/vitamin-k

 

[pellicle]

Classically that link contradicts its assertion within a paragraph

There is increasing evidence that vitamin K improves bone health and reduces risk of bone fractures, particularly in postmenopausal women who are at risk for osteoporosis. In addition, studies of male and female athletes have also found that vitamin K helps with bone health. However, some studies have found that vitamin K didn’t help with bone density.

I have found nothing in peer reviewed papers that suggests the link between warfarin is more than related by the selection of elderly people who are not active. There is a lot on "the web" but then there are many things in supermarket magazines too.

To me the science is still inconclusive on warfarin and Osteoporosis.

 

[T in YVR]

I talked with my cardiologist about my initial question above and here is what the view of one cardiologist is (he's very good and I respect his opinion):

"There is no right answer regarding the valve choice. I think you have a good understanding of your options with respect to the valve. Both scenarios are possible later in life. I think the risk of autoimmune disease striking you later in life is low, usually these become apparent in your teens and twenties. But you are right that something else could come up later in life.

Fortunately with the mechanical aortic valve you are ok to stop anticoagulation for a few days if some other medical problem should develop. This is not the situation with mitral valves. But for aortic you are good. The chance of you needing another open heart surgery with a tissue valve is pretty high. I would not count on TAVI. It has a long way to go to prove it is equal to open heart bioprosthetic valve surgery in a young person like yourself. And a TAVI inside another prosthesis is a particularly special scenario. It may be possible but there is no way to know and it has a long way to go.

We should be able to manage most other conditions despite you being on Coumadin. I think you are right to be aware of the potential problems but usually it can be done. And in the case of severe bleeding we can stop anticoagulation for 2-3 days and deal with it. Although you can argue for either option, as you have done quite well actually, I think the benefit with the mechanical valve in avoiding further heart surgery outweighs potential complications from managing other health issues later in life."

On-X it is...I am sticking with my original plans.

T

 

[pellicle]

Glad you made a call and are happy.

Best wishes for an uneventful surgery and recovery.

 

[Protimenow]

One other thing that isn't discussed very often, but may have an impact on future medical issues is that there's ongoing work to develop a medication that can be used INSTEAD of warfarin. This may take Vitamin K out of the picture, because it works on different systems. It may reduce the likelihood of clots forming on a prosthesis -- and this may actually be helpful for other medical conditions(?).

It's good to see that you've made a decision. You should be quite comfortable with it. (And, too, perhaps by the time other health challenges occur, if they do, medicine will have advanced to a state where these major problems aren't as big or as hard to treat).