How coumadin and AFIB is handled before valve surgery

[cp172]

HI Guys & Gals,

I am expecting a call in a few days from my Valve Coordinator to let me know the recommendations on the best procedure to replace my mitral valve (TMVR or typical chest surgery). For the last week I have been in AFIB. Attempts to convert the rhythm by increasing amiodaron has not worked. I assume I will have to stop taking coumadin a few days before my procedure. This worries me as it increases the risk of a stroke. Should I push for a cardio conversion? Your thoughts?

Thanks for your help.

Mickey

 

[cp172]

Cardiologist has decided to do a cardio conversion tomorrow (Friday, 10/30). I had an ablation on July 6th and have already had one conversion. Hopefully this one will last until I have my mitral valve replaced in the next few weeks. I am hoping to hear from the hospital about options and dates by early next week.

 

[stephenismycopilot]

Keep your chin up. A rough few weeks ahead, but it'll pay off in spades!

 

[cp172]

Keep your chin up. A rough few weeks ahead, but it'll pay off in spades!

I appreciate the encouraging words. Thanks a bunch!

Mickey

 

[cp172]

Well I went in for cardio conversion and was told I was in AFIB. I was hooked up to the metal plates and an IV inserted. After about 20 minutes the cardiologist came in and said it looked like I was back in rhythm. They took two EKGs and yep I had converted while laying on the bed. The cardiologist said that I might have to get put on heparin prior to surgery when I go off coumadin. It is also possible the amiodaron finally kicked in and is doing its job. Not sure what to say.

 

[pellicle]

Hi

I assume I will have to stop taking coumadin a few days before my procedure. This worries me as it increases the risk of a stroke.

I anticipate that you'll go off warfarin and then that will be "replaced" by Heparin, which is called bridging ACT.

Heparin and Warfarin do similar things (prevent clots) from different angles. Heparin is short duration but fast acting, while Warfarin is longer in the system and requires a bit more of a balancing act. Heparin also acts in such a way that the INR measurement can not be used. as an "economics style" graph it goes like this:

Bridging is normally done with higher risk patients but all AC therapy is ceased for the first day or so after the surgery because coagulation plays a critical role in healing.

Its always a statistical thing, you know, likely or not likely. You don't just get a stroke instantly after going off ACT and the likelihood is estimated by your team depending on factors.

I'm sure they'll let you know exactly what they want you to do when it comes time to do it, but for those of us who like to think things through sometimes knowing makes it easier to be patient.

Good luck with the surgery ...

Best Wishes

 

[Jmprosser.lab]

Just curious if a pacemaker would fix this problem? Always seemed like a potential good solution with almost no downside? Curious if others can speak to this?

 

[cp172]

Just curious if a pacemaker would fix this problem? Always seemed like a potential good solution with almost no downside? Curious if others can speak to this?

Hi Jmprosser,

I don't think a pacemaker is an option for me. I am excited to report I meet with my surgeon Monday and hope to schedule the surgery ASAP. I will know more then.

 

[Jmprosser.lab]

Good luck!!! Keep us updated

 

[cp172]

Good luck!!! Keep us updated

Hi Jmprosser,

Will do. Matter of fact I just started a new thread since my surgery is scheduled.

Thanks

Mickey