Questions about types of valves

[Jetfixer]

Hello all,

I have recently been told that I will need a AVR. I have read through many of the testimonials and stories of other patients who had been through it and still have a few questions about them. I had some chest pain issues years back and was diagnosed as having MVP. Soo I took the chest pains as par for the course. I have visited the DR. regularly and was always told it was the MVR. I recently had some palpitations and went to the ER and after having a battery of tests cath, stress, echo, etc they came back with a diagnosis of a leaking AV. I am still in denial cause I still feel good but I am trying to figure out which type of valve to get when the time comes probably in a few months. I am a mechanic and can get cut on occasion and have a hobby of fixing anything I can. I was thinking about the st jude soo I won't have to worry about it again but any comments or help would be apprec

 

[Kate]

Welcome Jetfixer!
Like you, I had a bad aortic valve but almost no symptoms right up until my operation to replace it 9 months ago. One of the pesky things about aortic valves is that they can be like that - no warning signs right up until they become life-threatening. So, even though you feel good, make sure to follow-up on this before it gets worse!

Choosing what valve to get is very difficult. Happily, Tobagotwo (one of our members) put together a very balanced summary of the pros and cons for both options which you can find by looking in the "reference materials" folder - it is the first entry. In the end, there is no ideal choice for someone under the age of 65, so it becomes a matter of learning as much as you can about the options and figuring out which will fit best with your lifestyle. Personally, I chose a biological valve because I live in a rural part of Ohio with no Coumadin clinics, am a social drinker and take medication not compatible with Coumadin, and was generally more comfortable with facing a major crisis every 10 to 20 years than the daily minor risk of bleeding events. However, as you can see, these are very particular concerns that would not apply to everyone.

From what I have learned on this site, I would not think that your occupation as a mechanic would be reason to dismiss the mechanical option (unless your employer has a problem with it as some firefighters have reported on this site). It is true that people on Coumadin take longer to stop bleeding, but they do stop. Only a very major injury would be life-threatening and then probably only if you didn't have access to medical care.

Learn all you can and I'm sure you'll come up with the right choice for you! Take care, Kate

 

[Perry]

Welcome Jetfixer,

I started my research in November 2005 and had a mechanical (ON-X) installed in March.

You are probably right that if you pick a St Jude you won't have to worry about it again. That is primarily why I chose mechanical over tissue (though the Ross Procedure was my real #1 choice when it was an option for me). You will take coumadin and get your blood checked periodically. To me it's another pill. When I plan a ski trip I guess I may ask my cardio what he thinks. Look into ON-X & ST Jude and others

There are tissue valve (treated and reinforced pig and cow valves)manufacturers claiming valves may last 20+ years in some patients. There are promising valves. I am 42 and, with cardio and surgeons input, figured in me one would start to leak and go downhill in 8 to 12 years. Could be later, could be earlier. Look into Medtronics Free Style (Mosaic?), Carpentier Edwards and others.

Just a helpful start I hope. There is much to consider with this choice and some real good people here to talk with.

Get well!

Perry

 

[Magnus]

Choosing a valve is a very personal decision so you have to go with what feels right for you and not what someone else tells you. I opted for a mechanical valve because I'd rather avoid another surgery in the future if I can.

 

[Jetfixer]

Thanks Kate, Perry and Magnus. I appreciate the feedback. I guess that I have to take it all into consideration. I am 39 soo mechanical does seem to be a good option but the thought of worrying about my blood levels all the time is a bit much. I would hope that I would not have to get it done again in the future but there are soo many advances in medicine hopefully it might not be such a major operation 10-15 years down the road. The tissue valve is also appealing because you don't need the coumadin and I have heard from some of my moms friends it has some side effects. Don't know the specifics but the always go like ohhhhhhhhh you don't want to take coumadin its awful. How bad is it really? Thats the only drawback i guess.
CAn anyone be specific about day to day life on coumadin?

 

[Mary]

Thanks Kate, Perry and Magnus. I appreciate the feedback. I guess that I have to take it all into consideration. I am 39 soo mechanical does seem to be a good option but the thought of worrying about my blood levels all the time is a bit much. I would hope that I would not have to get it done again in the future but there are soo many advances in medicine hopefully it might not be such a major operation 10-15 years down the road. The tissue valve is also appealing because you don't need the coumadin and I have heard from some of my moms friends it has some side effects. Don't know the specifics but the always go like ohhhhhhhhh you don't want to take coumadin its awful. How bad is it really? Thats the only drawback i guess.
CAn anyone be specific about day to day life on coumadin?

Jeff,
The easiest way to get specifics about day to day life on coumadin is to read our Anticoagulation Forum. You'll see a variety of questions asked and answered on it.
It seems to me, if you can get your own home testing unit, that it is a fairly straight forward procedure once you get your levels established after surgery.
But only you can decide, so read all that you can in that Forum.

 

[mitchner9g]

Where's the "reference materials" folder?

Where's the "reference materials" folder?

Welcome Jetfixer!
...
Choosing what valve to get is very difficult. Happily, Tobagotwo (one of our members) put together a very balanced summary of the pros and cons for both options which you can find by looking in the "reference materials" folder - it is the first entry.
...

Hello Kate - I'm fairly new here as well and am trying to get as much info off of this site as possible about valve options. You mention a reference materials folder above written by tobagotwo. i could not find this; do you have a URL for it? i tried using the search form to no luck. thanks for any help!

 

[Kate]

Sure!

This link should take you to there -

http://valvereplacement.com/forums/showthread.php?t=14330

Welcome and - as I said before - as long as you are well-informed, you really can't make a wrong choice. Best, Kate

 

[Dustin]

Choosing a valve is a very personal decision so you have to go with what feels right for you and not what someone else tells you. I opted for a mechanical valve because I'd rather avoid another surgery in the future if I can.

Magnus,

What anticoagulation drug do they normally use in Sweden: Marcoumar (phenprocoumon), Sintrom (acenocoumarol), or Coumadin (warfarin)?

 

[Magnus]

Magnus,

What anticoagulation drug do they normally use in Sweden: Marcoumar (phenprocoumon), Sintrom (acenocoumarol), or Coumadin (warfarin)?

They only use Warfarin here; at least for heart valve patients.

 

[Perry]

A day in life on Coumadin.

I have been home for 2.5 months. I got my level checked daily when I first got home (a home nurse came by and took blood). That gave everyone an idea about my needed dosage. I just got tested Wednesday for the first time in three weeks. INR was slightly low - I think I overdid the broccoli and salad the 4-5 days prior. Once tresting became weekly (within the first month home) it became 'no big deal'.

Maybe I am doing something wrong, but now I don't do anything different than prior to surgery. From what I see, you take an amount of coumadin that will keep your INR in the range prescribed by the hospital or cardiologist. Just another pill, 5 mg per day taken with my multi vitamin and zestril in the morning. Everyone's dosage may differ. With the ON-X study underway and looking promising, I don't fear being near the lower end of the range.

Perry

 

[Ross]

Thanks Kate, Perry and Magnus. I appreciate the feedback. I guess that I have to take it all into consideration. I am 39 soo mechanical does seem to be a good option but the thought of worrying about my blood levels all the time is a bit much. I would hope that I would not have to get it done again in the future but there are soo many advances in medicine hopefully it might not be such a major operation 10-15 years down the road. The tissue valve is also appealing because you don't need the coumadin and I have heard from some of my moms friends it has some side effects. Don't know the specifics but the always go like ohhhhhhhhh you don't want to take coumadin its awful. How bad is it really? Thats the only drawback i guess.
CAn anyone be specific about day to day life on coumadin?

Jetfixer never ever listen to a friend of a friend! Coumadin is not a horror drug at all. There are so many people walking this planet naysaying on it, when they do not take it and are only broadcasting what they've heard without doing any research of their own. You do not have to change much of anything that you do, you can eat what you want, do what you want and be just fine. The drawbacks are, frequent INR testing to be sure your in range, certain surgical procedure will require stopping Coumadin and having bridge therapy instead, and not much else. You'll want to protect your head from sudden trauma if you do things like skiing or the like, sword fighting is probably not a good thing either. Basically it's all common sense stuff you do while on it. You bleed a little longer then someone who isn't on it, but you stop the bleeding the very same way--direct pressure to the wound for a little longer time. I've worked on cars, cut myself silly and always seem to find a way to gash myself. I have never had a problem stopping the bleeding.

Honestly, visit Al Lodwicks site as part of your research and read all you can. Doing this will dispell about 95% of the crap you've heard and will also allow you to know bs when you hear it. www.warfarinfo.com