Anyone had more palpitations or missed beats than usual after surgery?
I'm over 2 weeks post op with ON-X AVR, INR tested 3.0 earlier today at the lab. Today I suddenly got multiple palpitations. I could feel, and hear them in the stethoscope. My heart would beat like normal, then miss a beat or palpitate and then returned to normal starting with a bigger beat. This happened a couple times a minute, then would be normal for a few minutes, then a couple more for a minute, and slowly less often. I went to the hospital and my EKG and blood test are normal. Doctor thinks maybe I need to rest more, I probably do. I might get a halter monitor. Now a couples hours later they've calmed down to a few per hour. No other symptoms and I feel fine walking. My valve sounds the same tick/clink.
5 more days. On-X Mech vs Edwards Magna Ease 3300 TFX Tissue Choice
My surgery for mini sternotomy AVR is on march 12th. I'm having a hard time deciding on valve. After all my research, I'm leaning towards mech but then doubts arise. I don't want more surgeries, but all the little inconveniences and risks associated with warfarin bothers me.
I'm 30, young and healthy male. Live in Canada (are INR monitors and test strips covered?). Not a big risk taker but am mild-moderately active in weight lifting, cycling, exploring nature, some jujitsu, and light parkour, 2-3 times a week. I've needed a hospital maybe 4 times in my life, 2 separate fractured arm, and stitches on my chin from a park BMX accident. Don't care about other sports or physically risky jobs. I think I'm more afraid of injury than the average person.
I have severe bicuspid AV regurgitation which caused enlarged LV, very mild MVR. My my Aortic root has remained at 3.9cm for 10 years. It's expected to stay the same, but may possibly slowly increase in a few decades. My surgeon said my risk for aneurysm is extremely low. The rest of my heart muscle and MVR is expected to return to normal post-op. I developed mild shortness of breath and chest discomfort the past few months which prompted an elective decision for surgery. Surgeon anticipates to use a valve size of 21-23mm. He recommends an On-X mech but will do Edwards Magna Ease 3300 TFX tissue if I want. He didn't try to persuade me choose one over the other.
Valve Decision Pros, Cons, Concerns
- I'm sound sensitive but I'm OK with watch ticking noise at night, but will be annoyed if I hear it during activities and music.
- "<1% risk of requiring another operation for the valve specifically." -surgeon
- Minor inconvenience every couple weeks to monitor INR.
- Rely on medication like I rely on water to live.
- "0.5% cumulative risk per year of anti-coagulation complications." -surgeon
- Higher risk (how much?) of bleeding, but "likely won't be life threatening." -surgeon
- Feel and be more vulnerable to injury or possible accidents.
- Worry about possibility of no access to medication (travel, natural disasters). The coronavirus has already put my non-generic brand of antidepressant on back order until the end of this year.
- I Have OCD and I will probably obsess over INR and drug/food interactions depending on how important it is. That could be both good for my physical health but bad for mental health.
- Possible easy bruising? I currently don't bruise at all. I've ran into metal poles and only had mild bruising. Afraid that will change with warfarin.
- 0% increase risk of stroke after 15 years.
- Spend $$$ on medication and test strips but may have coverage.
- Less than 5% chance of needing warfarin after 1 year if I get AFib. -surgeon
- Won't be or feel more vulnerable to physical injury.
- Feel hesitant to be as active out of fear of wearing out the valve faster, but data doesn't support this?
- Major inconvenience every ~10 years.
- 1-4 OHS in the future. May only get 5 years out of first valve. "10 years average. 4th surgery is when complications increase the most" -surgeon
- Each surgery has <1% chance of death in surgery, 3% risk of reopening to look at bleeding, 2-3% infection of valve in hospital, 0.2% valve infection within 6months, 5% risk of needing pacemaker.
- Smaller tissue valves wear out faster? Mine will be 21-23mm.
- Months of symptoms (stenosis, regurgitation) during period of valve deterioration?
- Research suggests there is similar risk of stroke as mech valve.
- Spend $ on supplements that I think will reduce calcification of the valve.