Aortic valve

[carolinemc]

if you read the above journal article and then ask yourself "why would someone need to research this topic and write that" were this not a "thing" which has grown a life of its own.

like the Authors say: until controlled prospective studies provide firm evidence that dietary vitamin K intake interferes with anticoagulation by VKAs, the putative interaction between food and VKAs should be eliminated from international guidelines.

So don't feel I'm saying anything about you so much as about the medical establishment which perpetuates these myths.

Fundamentally the best thing you can do with ACT management is to get out of the orthodox system (especially in the USA) and go self management.

You'll note that the members here from the UK do largely self manage and a few of us from Australia too ...

its a sad state of affiars.

Like us from the US we diet accordingly to many factors. We also self-manage our diets and meds. Even the lab I use will recommend eating more greens within reason to help bring the numbers down. I do not eat salads much. But it helps when it is needed.

 

[carolinemc]

Well I'm supprised because the greens thing was brought up at the meeting I had yesterday. Is the blood work done at home on a regular basis and checked by a lab on occasion or done at home / lab only? I take medicine daily but I have been known to look in my pill box and see opps I didn't take any yesterday.This is thyroid and cholesterol and I won't die or have a stroke If I miss it. If you missed it and it got out of whack, What then? Does it fix itself or how would you know if a clot it on the valve that may break away and cause a stroke. I'm fair at taking my meds but not perfect. I'm being honest.

There can be time we miss a dose or two, that is where the green, leafy stuff helps. Just never stop for days on end, you could have an unplanned stroke. Mine was eye stroke that was possibly also caused by my diabetes also. In my left eye, still blurred vision, considered legally blind in that eye. Still have cataracts in there. Got the right eye cataracts done, wear readers to read and see the computer images. And there are regular strokes to think about. So if you miss one dose, not to worry. And to get a med pill box that has slots for 7 days, morning and evening. Helps to make you remember. And you can use your cell phone or computer for reminders also.

 

[Timmay]

… Thanks for the offer Timmay. I've been obsessing about this for a bit now and know more about it than I thought I'd ever need to know.

Easy to do. That said, be careful. The amount of stress and anxiety you might add into the mix has the potential of putting you in a rough spot (mentally and emotionally). OHS is already a lot to handle for most people (including me). Most of us DO get through it just fine … and the less stress and anxiety the better because there will already be a fair amount. Breathe. Get the input you need. Make a choice. And then hang on for the ride.

 

[Timmay]

@priley - If you want to see what home testing is like, I’ll extend the same offer as before. I’ll meet you for breakfast (or lunch) and I’ll show ya in person how it’s done.

We prick our fingers less than diabetics.

 

[DJ-Rae09]

I agree. Diet is up to you. Can eat or drink anything and easily adjust Warfarin dosage accordingly. Zero side effects. Home testing takes a couple minutes once weekly. I adjust my dosage as necessary and advise PCP. Very easy.

100%

 

[priley]

Very interesting interview. I'm glad that I watched it.

From the video

-They have been doing robotic aortic valve replacement since the beginning of the pandemic, so, a little more than 2 years.
- They have done about 50 of them, as of the time of the video.
-100% of the patients survived short term. Of course, having only been performed for a few years no long term data.
-He calls it ultra-minimally invasive, with even a smaller incision than the other minimally invasive options, offering quicker wound recovery time
-As a side note, he does mention that the 5 year outcome data has proven to be worse for TAVR than SAVR for younger low risk patients, making the point that TAVR is probably not a good choice for said low risk patients, in terms of low term mortality. I totally agree with this.

It will be really interesting to see if this robotic procedure becomes more popular.

I'll take a shot at what would seem to be the pros and cons:

Pros:
-Quick wound recovery time.
-So far 50 out of 50 survivors, but it is still early

Cons:
-About 2.5 years of experience and patient outcome data.
-Limited access in the event that a more involved procedure is called for. Personally, I'm glad that I did not have this procedure, because once my surgeon got his eyes on my aorta, he made a judegment call to replace it, as it appeared to be the tissue type that would potentially have an aneurysm later down the road. I'm glad that he made this call and it could not have happened in an operation such as this.

Although I would not choose this operation myself, I can certainly see the appeal. It will probably be a few years before the risks of operation are known and how that compares to OHS SAVR. Ultimately, one would expect that the outcomes would be similar long term, as you end up with the same piece of equipment attached to your heart. The long term issues should be the same- either reoperation or warfarin management. Once a few thousand have been performed there should be a better idea of how surgical outcomes compare to standard SAVR with OHS in the short term and eventually we will have long term data.

As has been the case with TAVR, regardless of limited data, I predict that they will have no shortage of volunteers given the appeal of a quicker surgical recovery.

@priley please share with us the outcome of your consult with Dr. Badhwar. This is very interesting.

Evidently by the time I met with him he had done over 125 surgerys i believe. His confidence in the procedure left nothing to worry about. Honestly I think this is his baby. He did ask if I minded others to watch the surgery and of course I said not at all. Dr's are coming from all over ,USA and overseas to watch him.I feel at peace with my choice of surgeons.

 

[Chuck C]

Evidently by the time I met with him he had done over 125 surgerys i believe.

That's good news. All things being equal, better that the number of practice runs he's had leading up to your procedure be in the 3 digits+ and not the 2 digits.

A couple of years ago when I was still looking at TAVR as an option I was able to watch a video of Dr. Curtiss Stinis of Scripps, the doc who would have likely done my procedure, completing a TAVR procedure. It was a presentation for the staff at Edwards LifeSciences, who made the valve. At one point, as he was feeding the catheter through the vein, it got stuck. He said this sometimes happens and knew just what to do, as he patiently worked it through the sticking point. It occured to me that I would not have wanted to been the patient the first time the catheter got stuck- better if the surgeon has encountered that issue many times before and knew the work around. The point being, the more experience a surgeon has with a given procedure, the more likely that he has encountered the various possible obstacles that he may encounter. Experience matters.

I feel at peace with my choice of surgeons.

Excellent! You have done your due diligence and it's now time to move forward and not look back.

Please keep us posted on how things go.