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You have an interesting dilemma. For unclear reasons you have at two biological valves fail in a relatively short period of time. Surgically implanted non mechanical valves would be expected to last longer than a TAVR valve. So if your valves didn't last very long then one might expect a...

When aortas are replaced the valve and aorta are usually replaced as one piece when a mechanical valve is involved. Not sure exactly why. Denton Cooley came through the room seemingly on roller skates prior to the surgery. Never saw him again. Post Op I stayed in a room probably used for...

First you are making an assumption that having a TAVR procedure is without risk. That is not true. Certain things are actually more common with TAVR than surgical valve placement. One is the risk of electrical conduction issues which may cause the need for a pacemaker. The death rate with...

I am not an electrophysiologist but I have had three ablations for A fib. Monitors are essentially small EKG machines which show rhythm but do not reveal the source or location of where the abnormal rhythm is coming from. Electrophysiological mapping is how the location is determined. The...

A somewhat similar story about the stents. I previously had two valve surgeries but had to have another due to a 6.5 cm aneurysm. My surgery went OK and I was discharged in about 1 week. But about 6 months later I started to have angina symptoms which I had never had. My right coronary...

I love the way this report starts: "Although the On-X aortic valve (AO) is considered less thrombogenic compared to its counterparts, we present a case where recurrent thromboembolic ischemic stroke occurred" I am not aware of any head to head comparison of valves that show the above assertion...

Having undergone three ablations and many cardioversions for A. Fib I can give a little perspective. The questions you should ask are what is the best guess on the effectiveness of the procedure. There are a few parameters that may help in the guesstimate. The duration of the rhythm problem...

Drug studies cost the drug companies a lot of money. The construction of the study is to maximize a positive outcome. So improving the warfarin side of the study with rigorous self testing when be counterproductive in terms of showing the new drug’s advantages. But to be fair, in the real...

The non warfarin anticoagulants are used because in the studies comparing them to warfarin there were proportedly more bleeding episodes with warfarin. These studies are used to justify the use of these drugs. As far as I am aware none of these studies required self testing of INR levels on the...

I don't know how one could say that the TIA is valve related when A. Fib is also present it could be either. Also there was a mention of already being on Eliquis when these episodes occurred. That would make me a bit nervous that the next episode might not be transient. An antiplatelet drug...

It is expected that the red blood cell count will go down after surgery. Blood is lost during the procedure. Generally if the body has iron stores or is given iron if the stores are low the blood count will gradually return close to the previous values. It varies from place to place when they...

I just thought about my own experience. My first surgery also was 47 yrs ago. So congratulations to both of us. I was 29 at the time.

lethargy = beta blockers most likely, to find out they need to be stopped with Dr’s ok Classic migraine with scintillating scotoma often without headache. Temporary partial blackouts in one eye strongly suggestive of TIA can be permanent. If you are going in and out of A Fib or staying in A Fib...

I have been using warfarin for 41 years. I have used non steroidal anti inflammatory drugs many times but in short courses often with proton inhibitors with zero issues. The concern about NS anti inflammatory drugs is real due to inhibition of COX 1 which has to due with maintenance of the...

The problem as I see it is that the current suggestion is very problematic with a very unclear duration of function and with no other options if the valve fails other than an open procedure. So without the possibility of an open procedure your life expectancy is strongly tied to how this valve...

Clearly a clip is not for you due to the stenosis. So it comes down to a procedure that might go 10 or 5 years or totally unknown. Then what? Still not sure why they think you are at such high risk for complications. I would get another opinion ASAP.

I too was faced with a 4th surgery about 8 yrs ago. I had 3 associated with the aortic valve and the aorta. But my mitral had markedly decompensated with insufficiency. I was between a 4th open heart and mitral clips. I was about to travel to the surgeon's location when I got a call...

Your story should have an explanation that is not too hard to find. I bicycle and I know very quickly when my function has deteriorated so I think your evaluation of your abilities is real. So is it valve related? Have you developed functionally significant mitral stenosis? Is there some sort...

One of the big concerns when numbers are thrown around about stroke risks with mechanical valves is the method of checking the INR levels on warfarin. I would anticipate worse results with “standard” testing than with proper self testing. For the most part few studies require self testing...

Good luck. Similar story. Was about to have 4th open surgery when surgeon changed his mind and pivoted to Mitral clips. Two days later had them placed at Cedars. So far 8 yrs later all good. Also procedure from my perspective was a piece of cake. Infinitely easier than open heart.