Plavix for my new valve

[glooney34]

I have an Edwards Sapien XT tissue valve encased in a chrome ring. Heart surgeon said taking Plavix for 6 months was essential to avoid clots.Now my cancer surgeon wants to eliminate blood thinners before surgery.Seems risky. I have an appointment with heart surgeon in two weeks to discuss. My cancer surgery was to take place at a hospital with no cardiac unit. so if something goes wrong...... Anyone have experience, comments or thoughts? Jerry

 

[pellicle]

Hi
as you know that anticoagulation (can't abide 'blood thinners', its not paint and its not thinned) for a tissue valve is administered only for the first 3 - 6 months, and then without other circumstances (like for instance AtrialFib) is discontinued. This is because experience has shown that for this period clots can form.

I didn't see when your surgery was so I can't be sure if you're past that point of time. I would consider it a risk but a very minor risk. I've got a mechanical and I've been off anticoagulation for some days after a surgery and nothing happened. I got the impression that such was common.

If you consider it from a risk view (where everything is a nonzero risk) its a risk but a very minor risk. An example:
* cross a street blindfolded
Yes, its a risk but it depends on where and what time. NY in daylight, with 4 lanes of traffic is a higher risk than a tiny mid-western country town at 3am on a back street.

My view is that surgeons are *very* risk averse, and if he's willing to get his name on it then the risks will be low.

that's my thoughts.

 

[Paleowoman]

Hi Glooney, I see you had a transcatheter valve and, presumably because of the chrome ring/stent thing they are more prone to clots than the regular tissue valves that are inserted with open heart surgery (I had anticoagulants for only four days after my OHS). I think that's why strokes are one of the 'risks' after transcatherter valve replacement. Definitley a good idea to talk to your cardiac surgeon, I would be inclined get him to liase directly with your cancer surgeon.

 

[glooney34]

My surgery was 10 days ago, 8/27/14. I saw my regular cardiologist yesterday and he would not give me a clearance letter if I go off Plavix. Liability issues.

 

[glooney34]

They do surgery while on blood thinners. From what I read, going off blood thinners results in a high percentage of strokes. Staying on them results in high percentage of blood transfusions. Anybody have thoughts? Or experience?

 

[tom in MO]

My mil had to go off warfarin to get her valve replaced and she did have a minor stroke. However, when the valve was removed, they told her it would not have lasted the month. She would have passed from yhe valve. She recovered and lived three more years. With her there was no option to remain on warfarin if she was to have the surgery, she had no transfusions for her surgery. It is a matter of relative risk and is probably your decision tp make. You may want a second opinion. If i were you, i would make sure the hospital has a modern unit for stroke care.

 

[Paleowoman]

I think the problem is that Glooney had a transcatherter valve replacement which has a different risk profile from a regular open heart surgery valve replacement, much higher risk of stroke, here I've been reading this: http://www.edwards.com/Products/TranscatheterValve/Pages/sapienxt.aspx?xtmedia=1

I really think your cardiac surgeon should be liasing with your cancer surgeon directly Glooney. All my consultants liase with each other.