Kevin's Posts

Glad you are adjusting to the new valve and hoping you can get your INR where they want it. Did the surgeon say why he thought the first repair failed? I had a robotic repair and it failed within 15 months due to the annuloplasty ring tearing away. They re-repaired my valve 8 months ago and I'm hoping it will not fail again.

If you check my journal, I wrote a post on living with anticoagulants. I think it is different for everyone, but after 6 months or so it becomes your norm and much easier. There is an adjustment period which can be short or longer, and then you get on with it. I haven't changed my diet at all (I just adjusted my meds around my regular diet). Alcohol in moderation is okay, but if you have many drinks it will affect your INR level. There are meds you shouldn't take when on anticoagulants (aspirin, anticoagulants...). If you need these meds, you then need to be aware of how they will affect your INR and so you will have to adjust your anticoagulant dose. It sounds complicated, doesn't it? But it isn't really. But as I said, after a period of adjustment, it becomes your norm. Your surgeon, cardiologist should be able to explain all this to you. There are many people out there leading active normal lives on anticoagulants. Of course in a perfect world, we wouldn't have to take any meds... Take care.

Hi Kevin. Just thought I'd add my two cents about your question.....I currently live outside London, England and have been on a blood thinner for about 4 years or a little more. I really don't find it an issue at all, as Rita said, it simply becomes a new norm for you, and you make a couple of adjustments here and there. I was first put on Coumadin, back in Charleston, SC where we lived for many years before our move here. With that type of thinner, or Warfarin, yes, there is a need for INR checkups, which take about 5 minutes usually at a lab. Here in England, I have the choice of going to my Dr's office with a designated appt, or to the pharmacy, and can walk in anytime I want, on the day for my recheck, or the next day if I miss. It is so easy. They then, inform my Dr. Electronically. Diet wise, I really haven't made many, if any, modifications. I don't eat a huge amount of spinach or southern type "greens" ( collards, etc) , but do have spinach once in awhile or spinach salads. The whole key is consistency. I do drink alcohol, usually wine or G&T, and just came back off a 2 week holiday where I pretty much had a drink or two every day. I also know that way too much will send my INR up higher, so there have been times I might adjust my dosage by 1 mg or so for a day or two, and that seems to work. It really isn't a big deal. It's kind of like taking a daily vitamin and with a little bit of time, you'll work it out. I will need to be on it most likely for the rest of my life. Doesn't thrill me, but what's my option? Also, there is a type of blood thinner available now that does not require monitoring as it works quite differently in your body. It isn't affected by diet, but the one hitch to that is that there is no antidote to a severe bleed if one ever happens, I.e. Car accident or something else. The antidote to warfarin or Coumadin, is a large Mt of Vitamin K which any hospital can administer. Hope this is good food for thought, and good luck to you!!

Hi Kevin. I'm sorry you have to have another surgery. The valve decision is not an easy one because there are pros and cons to both. And the decision is a very personal one. I had my surgery last year in May at age 59 and chose a tissue valve because I did not want to be on blood thinners. The tissue valves do last longer now than before and I've heard from others on this site that they last longer in "older" people - most probably because we are less active. I'm very happy with my choice. I was told by the surgeon that I may never have to worry about another surgery as the valve should last last least 20 years and by then I'll be 80 and a candidate for TAVR if I would need to replace it at all. He said it would "start going bad" in 20 years. That doesn't mean I'd have to replace it immediately. At any rate, I'm sure whatever decision you make will be the right one for you.

Even when you've done all your research, the decision is never easy. And there is no right decision, just the one you make. And then you move forward. So you'll hear both sides, but the decision is still yours. And hopefully you can get some unbiased advice from your surgeon as well and trust him or her. You're young so that is a big consideration. You're male so you don't have pregnancies or periods to consider, which can make mechanical more tricky. I had double valve surgery (mitral, aortic) and a repair on the tricuspid valve at age 54 because all my valves had stenosis due to former radiation treatment for cancer. My mitral valve and aortic valve are mechanical. There is an adjustment to everything, and as you know, you take anticoagulants with mechanical valves. And after a period of adjustment, you move forward and forget about surgery and taking meds, and life goes on. There are various new mechanical valves out there that require lower levels of anticoagulants. There are also tissue valves that are now treated with substances to make them more durable. It's a cardiac world that's constantly changing, as you know. Which doesn't help because the need to choose remains and there is a lot of medical marketing and the pros and cons for each valve remain. I'm not being very helpful, I know, but this is probably the hardest decision most OHS patients have to make, so I feel for you. But I also know that your decision will be the right one for you. And in the best case scenario that re-repair is possible! Take care.

I would try to get to the source of why the first repair failed - did the ring come loose, or was there some procedural error. I would find a surgeon who is confident he/she can re-repair if it's possible. There are very experienced surgeons out there, I would be sure you find the one who can give you the best shot at a life long repair. Best of luck!

I have a mechanical aortic and am 37. I agree that finding out why the valve failed first would be ahead of me making a choice. As for why I went with mechanical over tissue, honestly it came down to family history of heart disease and wanting to have the best chance at having to not repeat OHS if possible. After the fact, I found out INR and blood thinners was not an easy adjustment for me to make, though I recently moved back to the care of my GP and Primary Care team (and away from the hospital that was taking care of me post-op)... which seems to be a positive turning point overall.