Questions about AVR and Coumadin

[Phyllis Jean]

At age 55 I had my Aortic Valve replaced with a tissue valve. Until that time I didn't know I had a birth defect. I knew I had a heart murmur but nobody ever seemed concerned about it. My Aortic Valve was bicuspid with only two leaflets instead of the normal three. Well, here it is 6 years later and I have to have the tissue valve replaced with a mechanical valve. The heart cath. revealed that it is leaking very badly and is stenosed. This will entail taking coumadin for the rest of my life. The tissue valve should have lasted from 10-15 years. I would like to hear from anyone who has had a similar experience. I am very nervous about this operation and concerned about the Coumadin. My surgery is scheduled for this week. Anything you can tell me will be appreciated. THanks, Phyllis

 

[Rich]

Hi Phyllis
I am sorry to hear your valve is failing so soon.
I have not had a second surgery so I can't address that one, but there are a number of people here who have been there and I'm sure will offer their help.
As far as Coumadin goes it's really not a big deal but rather just a pain to deal with at times.
I had my surgery over eight years ago at age 58 at which time I received a mechanical aortic valve.
The only times Coumadin is hard to deal with is when other invasive procedures are needed.
This could include surgeries and things like a colon check-up for instance.
But there are ways to handle those situations.
Hopefully you will get through this surgery just fine, and with a little luck never have to do it again.

 

[mile high]

From my experience and research prior to my aortic valve replacement, typically the pig valve is used for older persons than you. Certainly it is a choice for anyone, but the expected life of these is much shorter than the metallic valves. Interestingly tho I asked my surgeon prior to surgery which he would choose and he said the pig valve and he was my age, about 48.

In any case, I have been on coumadin for two and a half years and have no problems. The biggest exposure of being on coumadin has to do with invasive procedures which could cause bleeding and thus there are procedures you need to be aware of to follow. Like many things coumadin usage requires discipline in your lifestyle, meaning exercise, steady eating and alcohol habits.

Good luck with your decision.

Mile high

 

[ALCapshaw2]

Welcome aboard Phyllis !

I'm curious, what type of tissue valve do you have?

I was hoping to get a Bovine Pericardial Tissue Valve since they last longer than Porcine valves but ended up with a St. Jude Mechanical Valve due to radiation damage to my heart for a previous problem.

Coumadin has not been a big deal for me since my INR is pretty stable. I still do a lot of outdoor work, bump, bruise, and nick myself and just keep on going. Cuts take a little longer to heal than before but nothing serious.

I recommend that you look over Al Lodwick's website, www.warfarinfo.com which should tell you just about all you need to know about dealing with Coumadin. Al is a Coumadin Clinic manager and monitors the Coumadin Forum here on VR.com

You may also want to look over some of the third generation mechanical valves such as those made by ON-X (see their website and / or do a Search here on VR.com for ON-X). They claim to have better 'hemodynamics' (flow characteristics) and less liklihood of causing clots to develop than the standard mechanical valves.

Where are you having your surgery and who are your Doctors? (Forgive my curiosity)

'Al'

 

[Phyllis Jean]

Answers to Al's questions.

Answers to Al's questions.

Al, Thanks so much for responding. The first valve I received was a Toronto Stentless, Porcine, Aortic Valve. Like I stated, it has only lasted for 6 years. I am having the surgery on Oct 6th at St. Joseph Hospital, here in Lexington, KY. My hematicrit level is still not too good, but Dr. Sekela wants to go ahead with the surgery due to the severity of the Aortic Valve. I don't know how much longer I can go on feeling like this anyway. I will be glad when it is over. It was nice to talk to you. Best wishes always. Sincerely, Phyllis

 

[Guest]

We wish you all the best.

 

[Nancy]

My husband has had three heart valve surgeries, he has two mechanicals and had a repair on one of them.

He's been on Coumadin for 27 years. For him it is no big deal, really. He takes it right along with all the other pills he takes. Many of his other meds have had serious side effects, but not Coumadin.

The only time it becomes a little bit of trouble for him is when he has to have some sort of invasive procedure. But his docs know how to manage those.

When he was younger, he was very active, and even then Coumadin didn't bother him.

Without it, he would not be here. It's a small price to pay, for him, anyway. Others will have differing opinions. But that about sums it up for Joe.

 

[Phyllis Jean]

Porcine Replacement Valve Leaking severly

Porcine Replacement Valve Leaking severly

Thanks to all of you for replying to my questions and concerns. This is a wonderful site. I wish I had known about it before now. I enjoy hearing about your experiences with Valve surgery. I have learned a lot in such a short period of time. Everyone is so nice and helpful. My porcine replacement valve, that I have had for 6 years, has to be replaced. I am coughing so much, due to fluid buildup, that I have difficulty sleeping. I am taking a fluid pill but it doesn't help a whole lot. Has anyone else had this coughing problem? I have to sleep on two pillows to elevate my head. I can't lay on my back or left side, due to coughing. I can only lay on my right side. I will be going in on the 15th of October to have a mechanical valve implanted. I just wonder what would make the porcine valve go bad so quickly. Did my body just reject it or was it something else? Sincerely, Phyllis

 

[bvdr]

Hi Phyllis Jean,

I don't know how I missed your posts but somehow I did. I too want to welcome you to this site for it has helped every member here.

I think the problem with breathing laying flat, the coughing, shortness of breath, and sleeplessness are problems that many of us also experienced. It is amazing how fast they worsen once they begin, isn't it? I went from one pillow to two to three in just a few months. Most nights I can now sleep with one and I haven't been appreciating that as much as I should.

We would all rather not have to take coumadin but somehow it too becomes routine and part of one's everyday life. I would never avoid a mechanical simply because of coumadin but some others feel differently.

I hope you make yourself part of the family around here once this re-do is behind you. I'll keep you in my prayers until you are safely back home. Please have someone post for you if possible because we all will be anxiously waiting to hear.

 

[geebee]

Welcome

Welcome

Hello Phyllis Jean,
Welcome to the website. Just an FYI, I have had 3 surgeries and have been on coumadin for 24 years. I currently have a St. Jude mitral valve which has been in since 1994. I am going strong and hope to keep this valve for the next 50 years.
I treat Coumadin just like the Inderal and Lasix I take. It's just another pill. Sure I have to have blood tests and I am currently looking into home testing but my day to day life is no different from non-coumadin users. I bruise easy and have to be concerned about cuts and the like but who doesn't.
The major thing is the procedures of dealing with Coumadin if you have to have other medical things done but your doctor will walk you through anything that may come up.
24 years is a long time to be on Coumadin so I may be a good source of info. Just try not to fret too much about it and I think you will find it a small price to pay for getting a valve that will probably last forever.
Take care,
Gina

 

[ALCapshaw2]

Hello again Phyllis,

Generally speaking, tissue valves deteriorate more rapidly in people under age 60. I don't know if it's a matter of blood pressure, metabolism, or other factors.

Also, Porcine valves typically have shorter lifetimes than other tissue valves. That is why the Bovine Pericardial Valves are favored by many patients and surgeons. They are approaching durability numbers of 20 years when implanted in 'older' patients. You may want to discuss this option with your surgeon if you want to avoid coumadin and are willing to face a third surgery in your 70's. Tough choices, I know. When given a choice, most people opt for the valve whose negative aspects they feel they can best live with.

Best wishes,

'AL'

 

[JimL]

I was coughing so bad before surgery that I couldn't possibly sleep lying down. Every time I lay anywhere close to flat, I would have to sit up coughing to get my breath back. The only way I could be close to comfortable was to sit at a table and lay my head down on that, which didn't make sleeping very easy. All that coughing will change after your surgery on the 15th.

 

[Guest]

I have heard that laxatives are good for a cough. After taking them you are afraid to cough!! Do not try this at home. Leave it to the professionals.

 

[Granbonny]

Hi Phyllis Jean

Hi Phyllis Jean

I will bring your post back up..Got off side-tracked..so your surgery will be this Friday, the 15th... I will post again. in the pre-surgery thread.. We will all be praying for you. You will be fine Bonnie