The Blood Thinner Woes

[Dina]

Hi, If you remain in A Fib ,Do your doctors plan to do an ablation?I had it
done for a Flutter and they tell me that the ablation is easiest to do when
you are in an active arrhythmia(its easier to find). There is no need to be
opened up surgically , it is the same level of invasiveness as an angiogram.
I also had a cardioversion and while it was successful , it did not remain so.
The Best to you,

 

[Bryan B]

I went into afib in the OR after they restarted my heart. Obviously I was in no position to ask my surgeon whether or not starting me on IV Amiodarone before trying other alternatives first was the right choice. I stayed on the IV Amiodarone for 24 hours and was then switched to the oral tablets. I stayed on the oral tablets for approximately 4 weeks (including 3 days in the hospital) with my dose reduced in half after 2 weeks. I have never had another episode of afib since that one time in the OR. My surgeon was the chief of pediatric cardiothoracic surgery at Duke Medical Center...I decided to go with his decision. I know there are some cardios/surgeons/GP's that probably don't follow their patients closely enough to make sure Amiodarone is not causing serious side effects. For longer term use I believe you are supposed to have regular tests to check your liver fuction. But for short term use after VR surgery I believe it is a very effective drug to stop a patient's afib long enough for their heart to settle down after undergoing serious trauma from the surgery.

As far as going on Coumadin post AVR, my surgeon didn't feel I needed anything other than low dose aspirin...but I had a Ross Procedure so it's probably a different set of circumstances than recieving a tissue valve.

 

[Karlynn]

Bryan, if you weren't reverting back to a fib periodically since the OR, that is probably why they didn't put you on Coumadin. If you had been going in and out of it, you probably would have been put on it.

 

[Bryan B]

Bryan, if you weren't reverting back to a fib periodically since the OR, that is probably why they didn't put you on Coumadin. If you had been going in and out of it, you probably would have been put on it.

I agree Karlynn, but from what members have said here they are put on a short regimine of Coumadin (2-3 months) after having a tissue valve implanted even if they didn't have afib while in the hospital. I think because they use your own valve and implant a homograft valve in the pulmonary position RP patients must have a lower risk of clots after surgery. I also wonder if by taking Amiodarone for a month after the surgery that allowed my heart to "simma down" and possibly prevented further episodes of afib. Anyway I would have gladly taken Coumadin if I continued to revert back to afib. I'd much rather deal with Coumadin than a possible stroke. I think in my case my heart was just being cranky after being started back up after a long surgery and a lot of moving valves around. If my autograft ever needed to be replaced before I reach 60 I would probably go with a mechanical valve to hopefully avoid a 3rd surgery. I hope I'll never have to make that decision though.