62 years old and meeting surgeon in 10 days to decide on valve type

[user 15848]

Hi All !

Had my AVR surgery on Nov-9th, 14 days ago.....
Received a mechanical valve On-X, and although INR is up and down due to an arrythmia developed after surgery and its pills, i can only say
"I made the rigth choice", "I hear no noise what so ever"
Although, dont have my full strengh back yet, i can not compare this moment to 15 years of managing AV stenosis.....
I can only climb stairs one step at the time, but i do walk for 20 minutes at the moment

Thanks to all for your comments.

Now, starting to learn how to control the INR within my range, but it is jumping due to drug interactions.

Will keep you informed about progress.

mj

 

[dick0236]

Glad all has gone well for you. For someone who has undergone OHS two weeks ago you seem to be doing very well. The warfarin routine might take a few weeks to settle down.....but it will. Get yourself a pill box so you know if you have taken the pill....or not. That will eliminate anxiety if you forget, and you will, to take a dose.

 

[pellicle]

Hi

welcome to "the other side" ...

Received a mechanical valve On-X, and although INR is up and down due to an arrythmia developed after surgery and its pills, i can only say
...
I can only climb stairs one step at the time, but i do walk for 20 minutes at the moment
...
Now, starting to learn how to control the INR within my range, but it is jumping due to drug interactions.

All sounds like you're exactly on the right track

Don't fret too much about the INR yo-yo, it settles down eventually (to within a range). It jumps around due to many factors at the momemnt. Its not even really a problem that its all over the shop, as long as its between 2 and 4 most of the time you'll be sweet.

Best Wishes

 

[honeybunny]

Glad to hear you are well on your way to recovery! You'll do fine with your IRN because you are clearly determined to do so. Do keep us posted.

 

[user 15848]

Hi

welcome to "the other side" ...



All sounds like you're exactly on the right track

Don't fret too much about the INR yo-yo, it settles down eventually (to within a range). It jumps around due to many factors at the momemnt. Its not even really a problem that its all over the shop, as long as its between 2 and 4 most of the time you'll be sweet.

Best Wishes

Hi Pellicle, eThank you for all your messages, they were and are important.
INR seems to be settling down now around 2.1, taking 2mg a day. Hope within 6 months it will be more inside the control limitsFor the next 3 months my limits are 2.5 to 3, and then probably will go to 1.5 to 2 as recommended by On-X.

Best regards,

michael

 

[user 15848]

Hi

welcome to "the other side" ...



All sounds like you're exactly on the right track

Don't fret too much about the INR yo-yo, it settles down eventually (to within a range). It jumps around due to many factors at the momemnt. Its not even really a problem that its all over the shop, as long as its between 2 and 4 most of the time you'll be sweet.

Best Wishes

Hi Pellicle, eThank you for all your messages, they were and are important.
INR seems to be settling down now around 2.1, taking 2mg a day. Hope within 6 months it will be more inside the control limitsFor the next 3 months my limits are 2.5 to 3, and then probably will go to 1.5 to 2 as recommended by On-X.

Best regards,

jlcsn

 

[pellicle]

Hi Pellicle, eThank you for all your messages, they were and are important.

since an actual visit in the ward is difficult the least I can do is a virtual visit ... at least I won'd blunder in when you're sleeping ;-)

 

[Silver Bullet]

Hi jlcsn2015. Glad to hear that your surgery went well. I would encourage you to monitor your INR at home. There is reasonable data that home INR monitoring makes a big difference in outcomes.

I suspect that the arrhythmia you are having post operatively is atrial fibrillation or flutter. Did you have that before the surgery at all? If it persists beyond a few months post-op, then the On-X valve will have made extra sense for you since had you chose a tissue valve, the AF would have required you to take an oral anticoagulant long term anyways. But let's hope that the AF settles down and doesn't come back to bother you. On-X was a wise choice regardless. Best of luck with everything.

 

[user 15848]

Hi Silver Bullet,

Thank you for your posting. During these first past 2 weeks out of hospital i have been going to blood lab for testing twice a week and also doing ST with the coagucheck,
i always find the home test is 0.2 or 0.3 below the lab result, but it does give me a very good idea of what is going on.

The arrythmia and the AF started 2 days after the surgery in the hospital, never had it before.

My next first visit to the cardiologist will be next week friday, they will do ECG and an Echo,

I am very happy decided on the On-X, i cant imagine adding to everything else the thought of having an upcoming surgery 12 years from now or less.

Best regards,

jlcsn2015

 

[user 15848]

Dec-14: Met my cardiologist past friday, not so good news for me this time.
They did an ECG and Echo , and found that the valve is leaking...., but it sits properly...
Not sure why this happen nor how bad news this is, but it was a sad to hear 5 weeks after AVR

Any one came across something like this ?

My INR seems to be more or less becoming stable after they got me OFF Amidorone, taking 2mg a day for now,
INR target for 3 months is 2.5 - 3.

Tks;

jlcsn2015

 

[pellicle]

Hi

sorry to hear that things are not perfect. I don't know how much leaking, but its actually normal for there to be some paravalvular leak (leaking around the valve). I think that this can actually settle down over time. I expect that they will keep an eye on it.

I'd ask them that question (will it stop, what harm is it).

Best Wishes

 

[DachsieMom]

My cardio thought I had a para valvular leak at my post op echo (8 weeks post op). Surgeon said it was basically impossible due to my type of valve. Had another echo at hospital (vs cardio office). That person also thought possible leak - however, my surgeon said my valve conduit can often be misinterpreted for a leak - it is just the way my valve works. I have a St Jude Conduit.

 

[harrietW]

Jlcsn2015
Congratulations on being through your surgery and on the mend. I'm glad that you are happy with the choice of a mechanical valve although your trouble now with leakage and although l really have no experience with this as l am still waiting for my surgery but have read on the site and else where that this can happen. I don't kniw if it's manageable or a temporary issue. My thoughts are with you and hopes that it is something that is manageable. As l too am having double Valve replacement surgery the first part of January 2016

 

[user 15848]

Hi

sorry to hear that things are not perfect. I don't know how much leaking, but its actually normal for there to be some paravalvular leak (leaking around the valve). I think that this can actually settle down over time. I expect that they will keep an eye on it.

I'd ask them that question (will it stop, what harm is it).

Best Wishes

Hi, thank you, have my first visit to surgeon in january, and then back to cardiologist march-11.
I also hope this is , "for me" , part of the healing process. Will see what they see in january and march,
for now learning to manage the INR. Once a week go to lab test, once a week do a coaguchek home test

 

[user 15848]

My cardio thought I had a para valvular leak at my post op echo (8 weeks post op). Surgeon said it was basically impossible due to my type of valve. Had another echo at hospital (vs cardio office). That person also thought possible leak - however, my surgeon said my valve conduit can often be misinterpreted for a leak - it is just the way my valve works. I have a St Jude Conduit.

Hi, i really hope this is just part of the healing process for me, but it did shook me down all weekend....
thank you for your thoughts.

 

[user 15848]

Jlcsn2015
Congratulations on being through your surgery and on the mend. I'm glad that you are happy with the choice of a mechanical valve although your trouble now with leakage and although l really have no experience with this as l am still waiting for my surgery but have read on the site and else where that this can happen. I don't kniw if it's manageable or a temporary issue. My thoughts are with you and hopes that it is something that is manageable. As l too am having double Valve replacement surgery the first part of January 2016

Hi, i am thinking positive and hope-think-wishing this is part of the healing, it really surprised me, but hope all gets fixed by itself.
Good luck with your upcoming surgery,

all the best !

 

[user 15848]

Hi !, as time goes by, i more questions regarding how to learn how to live with my new opportunity with a mechanical valve;
i thought of moving into another postings, but decided to stick to my original entry so anyone looking for "other people experiences"
could follow through my decision process and living with the outcomes.

Before surgery i used to take a lot of supplements, and they did good to me; at the hospital they only told me to drop gingko biloba,
tumeric and CoQ10, and so i did.

Now, i slowly going back into my Vit-C, but have other pills on hold for now until inr settles down.

I do think the "Amidorone" i was given for the arrytmia some how interfeered with the inr,now i am only taking metoprolol 50mg a day
and at night take a 500mg tylenol, some little pains here and there when go to sleep.

 

[user 15848]

3 Months after
Hi, this is just to close my entries under this subject, as from now on will be joining other discussions.
All is as it is supposed to be with my On-X valve, the issue found by the cardiologists are based on the
fact that the On-X shows a different pattern on an echo test compared to other valves, so the "jets" that
are present are normal according to my last closing meeting with my Surgeon.

INR was told to keep it between 2 and 3, and thus far have managed to find the path to stability,
and here and there i eat something i know may have an effect on it, but it is very maneagable.

Also, as i developed AFIB 2 days after the surgery, have been taking Metoprolol ever since, 50mg
a day, but am on the way to slowly remove it and see what happens.

This is my last entry here, but i want to say again thank you to all the people that shared their thoughts
during my decision making process to choose an On-Valve ,

But, i will be joining other subjects, probably those related to taking Warfarin and living with it.

Best regards !

 

[newarrior]

Welcome to the forum jlcsn2015 ! I was 60 years old when I got my valve, a pericardial Carpenter Edwards Magna Ease aortic valve. My cardiologist and cardiac surgeon didn't even question me wanting a tissue valve, they were both perfectly happy with my preference. The reason you don't see people walking round with that particular valve from 20 years ago is that those particular valves weren't developed until more recently. Yes they made pericardial valves 20 years ago but they have refined them every few years and now they last longer than they did when they were first invented. I do not mind having a 're-do' though which is surely on the cards for me. The fact that I do not hear ticking in my chest and do not have to take warfarin every day more than compensates for the pain and stress of a 're-do' (and I didn't have it particularly easy when I had my surgery). Right now the only thing that tells me I've got a bio valve is seeing my incision scar and memories of the surgery and ongoing check ups with the cardiologist - I liken it to having a crown on a tooth, it feels your own as you can't notice the difference between it and the natural one.

Harriet - I would hate to hear the ticking of a mechanical valve - it would be no joke to me. I know for some people hearing the ticking is reassuring but for others that would be quite the opposite.

Harriet - I would hate to hear the ticking of a mechanical valve - it would be no joke to me. I know for some people hearing the ticking is reassuring but for others that would be quite the opposite.-AMen

 

[newarrior]

Welcome jlcsn. I understand your need to share. It is a life-changing decision either way, isn't it?

My backstory is very similar to that of Paleogirl. In fact, I communicated with her privately to help in my decision to go with a tissue valve. I just turned 61 and though the thought of a re-do (very likley) is not a pleasant one, the deciding factor for me was the ticking of a mechanical valve. I'd made up my mind to deal with the warfarin when I read a post about potential ticking and, like Paleogirl, I would find that very difficult to live with. My surgeon was good with either type at my age.

Regarding the longevity of tissue valves; like you I've seen stats that state up to 20 years. However, from posts I've read on this forum, 10 years seems to be closer to the norm. Another point to consider (and pellicle can verify this for you), it is possible that even with a tissue valve I may need to take warfarin. It's not a strong possibility but it is a possibility.

My surgery is less than a week away (9/30/15). Last week, following my heart cath, I was invited to particpate in a clinical study for a new type of Edwards tissue valve that will require less time on the heart-lung machine. I'm pretty excited about that.

I'm confident you will find the folks on this forum as helpful as I did. IMO, no amount of research can compare with talking to others who have been down this road.

How's your valve?)