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Hi Zara, Hope you are going well. Have you decided tissue or mechanical yet? Warfarin is a big challenge with pregnancy. Warfarin creates birth defects so clexane injections are generally required throughout the pregnancy. Full anticoagulation excludes epidurals or spinal options for delivery...

Possible reasons for the valve area to inaccurate (it doesn’t make sense that the valve area would increase with time) 1) valve area error due to mitral valve interference before it was fixed 2) valve area involves making a measurement that has error and then squaring it - so any error is...

Some of you have been having a rough time. All that painful bridging. What would I do? For the first two days take about 150% of my normal dose (if the usual is 6mg, take 9 or 10mg for two days) then check my INR and fine tune from there. It is so much easier when you have the keys for the...

Hi pellicle, Best wishes with your arrhythmia. The scarring from heart surgery can certainly change conduction in the heart leading to arrhythmias. However, arrhythmias are also common in people with structurally normal hearts who have had no heart interventions. The association between AF...

Thanks Chuck C, This is the second randomised controlled trial (RCT) looking at the timing of surgery for severe aortic stenosis. The other one was by Kang: Early Surgery or Conservative Care for Asymptomatic Aortic Stenosis - PubMed Both are small trials so we won't know the definitive...

That is great that both St Jude and ON-X are equally good. No need to worry about what brand was placed in your chest or what brand will be placed in your chest. (Though, might upset some advertisers)

There may be a couple reasons why new mechanical valves are so noisy at first but get better with time: 1) Before the valve replacement, your heart thickens or expands to pump harder to compensate for your tight and/or leaky valve. When the valve is replaced, initially your heart continues to...

Hi Pellicle, Happy New Year to you . 🎄🎅😄 The optimum timing for valve replacement surgery is a complex issue. Surgery has its obvious risks. This needs to balanced against permanent heart scarring from letting a heart start to fail. For aortic stenosis there has been only two randomised...

Thanks ETC908 for your careful summary of this complex topic. I agree that it is choosing between two good options (no surgery is very bad). I feel that Arnold Schwarzenegger is a good example of a Ross procedure. Avoiding warfarin allowed him to continue his action movie career - fantastic...

That’s an interesting idea. Does vitamin K from greens really have a strong effect on INR? The mechanism is plausible because warfarin blocks formation of the active form of vitamin K that is required for blood clotting factors. Just because it is plausible doesn’t mean that it works. Are there...

I agree with Pellicle, I eat a lot of salads and try to be fairly consistent with frequency and amount. My warfarin doses reflect my salad intake, rather than avoiding to salads to protect a warfarin dose.

Hi AI3x, I hope you have managed to get some more sleep last night. I had a similar unpleasant experience trying to grab some sleep. A few points on reflection: 1) I normally sleep on my side. On my side, I don’t snore. However, I think that I snore/airway obstructs when sleeping on my back or...

Hope your consult went well. TAVRs are a game changer. Such a quick recovery compared to the old valve replacements. Best wishes

I have my fingers crossed for you. It is reassuring that the last scan was good. Best wishes

You have a plan. I’m guessing that you also have a date. Best wishes. After some time, you will get back to “normal”. You will hopefully be healthier, fitter and taking things less for granted than if the valve problem didn’t occur.

This sad case shows that for some young people, a tissue valve replacement is the safer way to go. This would also include people who live in small communities far from medical services, for example, outback Australia. Warfarin compliance is more difficult for some people for multiple reasons.

Before my operation, I worried about waking up with the breathing tube. I was pleasantly surprised to wake up with no tube and not too much pain. My plan for if I did wake up with the tube still in, was to try to relax and point to the tube. This would show the staff that I was too awake to need...

Hope that your double vision episodes have settled. Sounds like your eyes were each working (good) but temporarily not coordinating properly. Maybe a migraine related event. I occasionally experience these episodes. When I was in hospital, Seinfeld was on TV. I soon realized that I couldn’t...

Extended use of NSAIDS (anti-inflammatories such as ibuprofen, diclofenac) can weaken the stomach’s acid barrier lining. This can lead to ulcers. Stomach/duodenal ulcers (which often bleed) + warfarin = trouble Occasional NSAIDs use is unlikely to be a problem. I do use ibuprofen occasionally...

Hi rich01, I hope that it has all settled down. If it hasn’t, you know your body better than anyone else so get it checked out. As you indicated in your post, I would expect shortness of breath to occur from clots or pericarditis. Common things (muscle pain) occur commonly, however be careful...