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It depends. First how old are you? Will the cancer affect your life expectancy? Will you be needing more surgery for the cancer? Will anti coagulation make treating the cancer more difficult? The cancer itself probably will have little affect on the valve of any type.

When I went to medical school we were taught a few things about post operative care. In GI surgery we always asked after surgery “have you passed gas?”. Then we knew the bowels appeared to be working OK. When drains are left in one watched to see when the drainage stopped - then they are...

I am not intimately familiar with the NHS. Can you go to a different facility? If the records are available it might not put you too behind. Good luck.

90%+ of hospitalized Covid patients are not vaccinated. So aside from prolonging everyone’s misery these patients are preventing care of those who need it for other issues. So I can understand why many people are frustrated and state things like “anti Vaxxers are the lowest of the low” Not...

Like everything else there are trade offs. There might be a mildly reduced thromboembolism rate if antiplatelet agents are added to warfarin therapy. It is not however a huge improvement certainly not 40%. On the downside that possible modest effect comes at a cost of increased bleeding. The...

I am a big fan of the fewer things needed to be done the better. Yet I have this long list of procedures. Each procedure has it's own risk so when one adds procedure to procedure the risk adds up. For example when I had my last big surgery in 2006 which was an aortic aneurysm repair with...

I am one of I believe many that have been very active on warfarin. Started in 1983 till now. Skied at a pretty high level until a few years ago. Still road biking over 100 miles / wk. Had one bike fall around 15 years ago where I bleed significantly into my leg. Had trouble climbing...

The problem with the On-X data was that it was not very robust. It was a small trial of less than 100 participants. If one looked at the data there was a higher risk of thromboembolic events and a lower risk of bleeding. The company concocted a combo statistic combining these two different...

Yes that is a plus. And now that I have continuous A fib warfarin is also necessary. But I don’t think that one is protected from stokes since some strokes are hemorrhagic stokes which would be exacerbated by anti coagulation. But every procedure has it’s own set of risks so to me fewer...

You will have two questions to think about. What kind of valves to put in the pulmonary and aortic positions? Tissue or mechanical. I would be surprised if the pulmonary is not redone since it has been in for 25 years which is usually past it's due date. With tissue valves no anticoagulation...

If these symptoms are real and reflect decompensation you need to inform the medical people to move up your surgery. In the US we call this “dicking around”. Get it done.

The usual routine is high dose IV antibiotics for a prolonged time. However there may be vegitations around the synthetic objects that may defeat the effects of the antibiotics. That is what they are trying to see with the echos. If the infection persists despite antibiotics surgery might be...

Details make a huge difference. It is common to have an area of akinesis after a heart attack (which can be silent). These areas are often associated with ectopic rhythms. So depending on what is found and details like your ejection fraction various things can be done such as an implantable...

38 years with two St. Jude aortic valves. Pre and post aneurysm surgery. When I think about it I hear it. Great for monitoring your pulse rate. Years ago I was helping someone in surgery. He asked me about my new watch. I said it was great.

My faith in the FDA has been shaken over the last year. The drug aducanamab ADUHELM, the New Treatment for Alzheimer's and Dementia | Infusion For Health was okayed by the FDA for Alzheimers. This was done despite any evidence for clinical effectiveness. A number of the people on the panel...

Continued good health and congratulations.

BP goes up and down so multiple readings are important to get an understanding of what is going on. Depending on age various numbers are used to decide when to treat. When someone shows up with a 170/100 reading I tend to think there is an underlying problem and the “white coat syndrome “ is...

This topic gets hammered on this forum a lot. Tissue valves are nice in as much there is no need for long term anticoagulation. But tissue valves have a lifetime that is less than human life expectancy. Say 10-20 years on average. So down the line another procedure would be needed. We...

Variants are going to continue to surface. Basically they are the viruses that beat the system the best. As long as there is a large reservoir of infected people all over the world these variants will continue. Hopefully if enough people are vaccinated and we don’t get a virus that breaks...

https://www.infectioncontroltoday.com/view/lambda-variant-of-covid-19-might-be-resistant-to-vaccines Again this is early data and speculative but mildly concerning.