Mechanical aortic valve and coumadin

[Missy]

A friend who says he has a mechanical aortic valve says his dr. told him that he might soon be able to get off the coumadin.

I am probably behind times but is this possible. I am aware that the new stents are such that after a year one may get off the coumadin. Are the valves the same?

Also his wife is a nurse and he takes a very low dose of coumadin... 2 mg a day and maintains a steady INR as his wife controlls it with food. Not by withholding food but by having him eat other foods that counteract vit. k.

I am aware that most of us do not buy into that but also aware that dr. tell us not to mix certain foods as they could contribute to a higher inr.. and going into surgery they ask you about supplements and things like that so I am beginning to think there may be something to it.

Any input from anyone???

I am on the verge of asking his wife but would like to know before I make a fool of myself.. I know that he is probably not telling all of it.. probably doesn't even know all of it. LOL But it really sound interesting as I have always wondered why the medical profession contradicts itself do much concerning this issue of vitalmin k and coumadin.

For instance , I just read a posting on the other site about Noni juice and one of the replies stated that it contained ginseng or something like that which could elevate the INR.

I don't have an aortic valve , mine is mitral and afib but still would be the same as far as this goes wouldn't it?

I also posted this on the other site.

 

[Country]

as far as i know, or at least read, there isnt any drug that will replace warfarin at this time. "soon" can mean a lot of things..... i have all sorts of time for "soon" to get here!

but i do believe that all the clinical trials have been stopped that would replace warfarin for aortic valves..... i could be wrong?

 

[nngbwh]

Let us know what you find out. I will be the guinea pig........... oink oink oink

 

[bdryer]

My cardiologist told me that Plavix and 81 mg ASA approval for MHV implants may be close to approval. Presently their is no substitute for warfarin.

 

[Bina]

Missy, I am also on a very low dose of Coumadin---17 mg per week---but that is only because of the way
my body processes the med. My diet does include greens and broccoli and other healthy veggies all in
moderation. Being on Coumadin hasn't been a problem so far, and I'm sure that it will be a daily med for
the next several years at least.
It would be nice to control our INR with ginseng, garlic, onions, and herbs; but that wouldn't be totally
simple to regulate either.

 

[Missy]

Bina, no it wouldn't be an easy task to regulate that but it must be possible to counteract some of the effects of vitmin k. If we knew how our body processed certain foods and at what rate it might be helpful.
Apparently, these people are doing something.

2 mg daily is even lower than mine and mine is because of the way I metabolize coumadin. I take 4 mg daily. He said he eats lots of greens and veggies and things.

 

[yotphix]

Each person is different and the range of coumadin doses required to maintain therapeutic INR is from as little as 1/4 mg daily to as high as something in the 20's I'm told by an INR clinic nurse. I eat veggies and greens regularly and am also quite physically active. I need 11 mg each and every day to stay between 2.0 and 3.0. It is my understanding that, with the possible exception of On-X recipients, AVR patients are not looking at any alternatives any time soon. Managing anti-coagulation with foods or supplements which are not standardized would be virtually impossible. Every bite or spoonful would be different than the last.

I'd be that your friend happens not to need much warfarin, and that when he says his wife manages him with diet, he means that she is careful to be consistent with his intake of foods which are high in vitamin K.

 

[Eva]

I wish to be able to get off Coumadin!! But I know this will remain a wish for a long time for us -- mechanical valves patients.

Do you know, Missy, which mechanical valve does he have?

 

[dick0236]

......Managing anti-coagulation with foods or supplements which are not standardized would be virtually impossible. Every bite or spoonful would be different than the last.

I'd be that your friend happens not to need much warfarin, and that when he says his wife manages him with diet, he means that she is careful to be consistent with his intake of foods which are high in vitamin K.

I agree with the above. I have taken as much as much as 70mg/wk for long periods as a younger man and currently take 35mg/wk as a "senior". My "gut" tells me that my metabolism plays the big part in my ACT. A reasonably consistent diet of vit K foods helps....but I would not try to manage INR with diet.

 

[njean]

Gosh Missy, I've yet to hear that you can be taken off anticoagulants with a mechanical valve! It would be nice but....

I would be really concerned if this kind of information was coming out of my doctor's mouth! :eek2: I'd be looking for another doctor, for sure!

I have never tried to control my INR through my diet and that is one of the reason's that I am so happy to have my own monitor so that I can keep a close eye on things before they get out of hand. Does your friend home test or go to a lab?

I wish your friend all the best but if I were him, I would certainly look into getting another doctor's input before stopping the anticoagulants!

 

[RZG]

As of Today their is no other anticoagulant other than coumadin for those with mechanical valves. Their is a new drug Pradaxa that is being used for Afib without valvular disease, and for those that have had a stroke. Pradaxa is being used in place of coumadin for those specific people. Hopefully other drugs are on the horizon that will be an alternative to coumadin for valve replacement recipients in the near future!

RZG Rachel

 

[WandaW]

I can live with the coumadin, a mistake or listening to the wrong advice is deadly. I am a rehab therapist and have seen the results of not following your coumadin score.

 

[Luana]

As of Today their is no other anticoagulant other than coumadin for those with mechanical valves. Their is a new drug Pradaxa that is being used for Afib without valvular disease, and for those that have had a stroke. Pradaxa is being used in place of coumadin for those specific people. Hopefully other drugs are on the horizon that will be an alternative to coumadin for valve replacement recipients in the near future!
RZG Rachel

The problem with Pradaxa is that there is not test to determine if you're in a safe range of being anticoagulated, and there have been incidents of bleeding, some fatal. No, thanks. Warfarin is a whole lot more predictable, not to mention costs a lot less, too.

Not sure why a Coumadin replacement is needed. It's been proven to be safe and effective and it's very economical. What's the problem? Eat your veggies, take your pill and forget about it.

 

[Jen]

There is a study involving the OnyX valve where yes, in the near future you MAY be able to come off coumadin. There is a trial going on now, but FDA has not approved it. My surgeon has been implanting OnyX from the "get-go", and he was asked to be part of this study. He said NO, not there is always the posibility that a stroke can happen, even if it does not show any affects. He said he would be inerested in the results and wheter FDA says yes, then he would go ahead. But yes, there is a trial going on.

Jen

 

[bdryer]

Luana

I'm with you regarding staying the course on warfarin! My cardiologist is adamant that Plavix and 81mg aspirin is in my future with my MAV. My AV is an On-X. I'm happy with staying on warfarin and 81mg aspirin maintaining an INR of 1.5-2.0, should the On-X proact study be successful. The INR clinic has got me stuck at 1.6 for the last 3 weeks, even though they are > the dosage 10% weekly. Best I've been in a month is 1.8. They aren't panicking to jack up my INR, then neither an I. [Looks like I'm involved in my own proact study.]

Warfarin is the gold medal standard when it comes to ACT. A blood test is required.....so what! We are required to be consistent in our diet......so what! I'm sticking with warfarin. We know what we are up against with warfarin, really what will the long term effects of plavix be? Who knows. As far as I'm concerned, plavix is in it's infancy and lacks the long term research of warfarin.

 

[Eva]

I was surprised how quickly I became comfortable with Coumadin/Warfarin after a couple of months of my surgery. So, taking the ACT pill has become a simple daily routine for me. I am grateful it is helping in keeping my heart ticking and helping me eat whatever I like without worrying about its color.

YET, although I have been able to stay within my INR range since my surgery, my skin has become extremely more sensitive than before ACT...my arms easily burn from the cooking vapor heat, the back of my neck hurts from the softest shirts' labels touching it (I remove the labels as soon as I purchase one), and I keep *discovering* new bumps and new bruises every day!

Anyone else??!!

 

[bdryer]

Hi Eva

I'm only 6 weeks post op. I'm 56 yrs old and on ACT for a MAV. I have not developed a skin, sun or heat sensitivity. I'm not aware of sun/heat or skin sensitivity being a side effect of ACT. Amioderone on the other hand made me sun sensitive for the short period of time I was on it.

 

[Jkm7]

Luana

I'm with you regarding staying the course on warfarin! My cardiologist is adamant that Plavix and 81mg aspirin is in my future with my MAV. My AV is an On-X. I'm happy with staying on warfarin and 81mg aspirin maintaining an INR of 1.5-2.0, should the On-X proact study be successful. The INR clinic has got me stuck at 1.6 for the last 3 weeks, even though they are > the dosage 10% weekly. Best I've been in a month is 1.8. They aren't panicking to jack up my INR, then neither an I. [Looks like I'm involved in my own proact study.]

Warfarin is the gold medal standard when it comes to ACT. A blood test is required.....so what! We are required to be consistent in our diet......so what! I'm sticking with warfarin. We know what we are up against with warfarin, really what will the long term effects of plavix be? Who knows. As far as I'm concerned, plavix is in it's infancy and lacks the long term research of warfarin.

You keep mentioning Plavix but are you sure you don't mean the new drug, Pradaxa?
Quite different. Plavix is commonly prescribed for people with stents.

 

[bdryer]

Indeed I am referring to Plavix. Plavix along with 81 mg aspirin is one part of the On-X study.

 

[Eva]

Hi Eva

I'm only 6 weeks post op. I'm 56 yrs old and on ACT for a MAV. I have not developed a skin, sun or heat sensitivity. I'm not aware of sun/heat or skin sensitivity being a side effect of ACT. Amioderone on the other hand made me sun sensitive for the short period of time I was on it.

I had always been sensitive but not as much since the surgery :confused2:

Thanks.