Valve Decision For 44-year old who loves beer

[Pat Heaney]

So, an update. My surgeon has installed 1000s of St Jude valves over 20+ years. She thinks an On-x is a good choice for me and will install it. Problem is she has not installed an ON-X before but claims the procedure is exactly the same as a St Jude. Is this true? I am now leaning toward just going with the more tested St Jude. Is there a practical difference between an INR of 2.5 and 1.8 anyway?

 

[dick0236]

........... Is there a practical difference between an INR of 2.5 and 1.8 anyway?

My target INR is 2.5-3.5 and I am most comfortable a little above 3.0.........and have never had a problem, neither stroke or uncontrollable bleed, at these levels. Personally I think the lowered INR target is mostly marketing.

PS: A 1.8 INR would keep me up at nite.

 

[DDT77]

I have an ONXAAP-25. Target INR range is 2.0-3.0. Some literature says lower is acceptable. No thank you.

I prefer INR from 2.6 to 3.0. I do not perceive a favorable risk / reward with INR below 2.5.

I don't know specifics of image below. However, my eyeball views risk @ INR of 1.5 is similar to that at ~4.5. Given uncertainty in testing and variability of life, do I want to be on the left side of the curve or right side of the risk curve?

 

[pellicle]

I don't know specifics of image below. However, my eyeball views risk @ INR of 1.5 is similar to that at ~4.5. Given uncertainty in testing and variability of life, do I want to be on the left side of the curve or right side of the risk curve?

similar to this one from a different study

 

[Protimenow]

From what I recall reading about the On-X valve, it's supposed to be slightly easier to attach one of the ends to one of the major arteries (sorry, I can't be more specific here). The valve, of course, doesn't have a success record to match the valves that are in common use - and have been for decades -- because they haven't been using On-X as long.

Supposedly, the likelihood of clots forming on the On-X is lower than that on the earlier valves because of better hydrodynamics (or something). Personally, if I had an On-X, I would want to have my INR in a range between 2.5 and 3.5. There's no lifestyle advantage to maintaining an INR below 2.0 - and, to me, too much risk involved in shooting for that laughable 'advantage.'

 

[carolinemc]

Hi everyone. New to the forum. I am a 44-year old man. Well, after monitoring my bicuspid aortic valve for years, I am scheduled to have valve replacement and aneurysm repair in a few weeks (aortic stenosis is severe; root dilated about 4.2). My surgeon seems to be pushing a mechanical St. Jude valve given my age but she has good things to say about the new Inspiris Resilia tissue valve as well. I am very active and love downhill skiing, cross country skiing, water skiing, and several other activities. Surgeon is confident I can continue with all these activities even if I go for a mechanical vale and have to take thinners.

My main concern with the mechanical valve is warfarin’s interaction with alcohol. I love beer (I do not drink anything else). On an average weekday I have about 3-4 super light Miller 64s (Miller 64 is 2.2% alcohol-not even real beer). But I do have 4 real beers on most Friday and Saturday nights (plus some 64s mixed in) and maybe 3 beers on Sunday. 4-5 times a year I drink 8-10 beers throughout the day at get-to-togethers and special occasions.

My question is whether this level of drinking is dangerous on warfarin/thinners?




Thank you.

I would suggest you to light up on the drinking beer, You drink too much on the holidays and special occasions. Just okay for the 3-4 during the week. Easy does it on the weekend. Good luck.

 

[pekster11]

the Op is almost the same age as me...with the same aortic valve replacement and aneurysm repair as me......and he has been given the same valve choices as me

are you my twin ?

 

[Pat Heaney]

But do you love beer, pekster11?

 

[SumoRunner]

I was 43 when I got a St Jude's valve. I'll be 72 in January. I never had problems with thin blood except a couple times when I injured myself competing in track & field. I have run upwards of 500 events from 200 meters to half marathon, and threw shot put for decades. ONE TIME, I tore a calf muscle badly at the track and my leg turned into a giant purple grape as the internal bleeding flowed down. Otherwise, running, throwing, swimming, biking, nothing caused a problem due to the blood thinner. (I'm sipping a beer now as I type.)

 

[pekster11]

i only usually have 2-4 pints of beer on saturday, when i'm out with friends

tbh i could quite easily give up alcohol completely

 

[pellicle]

tbh i could quite easily give up alcohol completely

Come on man, don't be a quitter...

 

[Pat Heaney]

Had my surgery Friday. Went with On-x. Hope to be home tomorrow! Feeling great. Surgeon grafted aorta because it was measured @ 4.5 once they opened me up!

 

[PAN]

Excellent. Hopefully all goes to plan tomorrow. Keep us posted on your recovery..

P

 

[pellicle]

Had my surgery Friday. Went with On-x. Hope to be home tomorrow! Feeling great.

good news ... now, keep up those breathing exersizes, don't lift stuff and follow the recovery instructions to protect your sternum.

That first beer is going to taste like gold ... any planned brews for your first after your cyborg transformation?

 

[Protimenow]

You had open heart surgery on Friday, and go home three days later?

Really?

Are they using a new 'rush them home' protocol, or am I missing something?

 

[LoveMyBraveHeart]

You had open heart surgery on Friday, and go home three days later?

Really?

Are they using a new 'rush them home' protocol, or am I missing something?

Mathias had his surgery on a Friday and went home on a Monday, then had surgery on a Wednesday and went home on Saturday, both times in August. Granted, if they would have kept him a day longer the first round in Aug., he likely wouldn't have been readmitted the following Wednesday. The first time in Cleveland, he was there 8 days because of pleural effusion. I would assume it depends on the surgeons thought. The surgeon in Cleveland was notorious for being conservative where as the surgeon here asked if Mathias felt well enough to go home because his thought process is that the body heals better in a comfortable environment. Not to mention, after his last surgery, they kept him in CICU the entire time...there was no "step down unit".

 

[Thomas]

Really?
Are they using a new 'rush them home' protocol, or am I missing something?

I had my surgery on Monday and went home Thursday morning. In retrospect, I should have stayed another day and waited for my INR to rise. Instead I had to do injection bridges for the first couple of days at home. Could have lived without that.
It was just soooo boring in there.

 

[Pat Heaney]

So, they want to hold me another day to get inr up. That’s ok with me

 

[tom in MO]

You had open heart surgery on Friday, and go home three days later?

Really?

Are they using a new 'rush them home' protocol, or am I missing something?

Seven years ago they told me I'd be home in 3 days. Didn't happen though, my surgeon wouldn't release me until my INR was stable for at least a day or so.

 

[Protimenow]

I guess they DO rush them out now. This is probably of proven benefit.

When I had my AVR in 1991, I was there for about a week (not that I needed it).

Years ago they kept people with 'heart attacks' in bed for weeks, from what I recall.

Maybe they've learned that sending patients home, if they've got good support at home, and back to familiar environments provides better outcomes than strapping them in a damned hospital for what the patients consider to be a LONG time. Perhaps it's primarily financial - maybe the insurance carriers don't want patients in the hospital for any longer than necessary. Maybe it's a bit of both.