Valve Selection Questions

[pellicle]

Hi

I realize I made an assumption which I would like to clear up

The fact that I am seeing people chart their results seems rather intimidating too. Is that a normal part of managing life on warfarin?

No, its not tyopical, its important to see that there are basically 3 ways to go (this is the assumption I made, you may not know this part).

1. some oer agency totally manages you. you walk in they sample e blood, they contact you and give you your dose. They may not even tell you your INR
2. self testing: you make the readings of your INR at home and call in your INR, they contact you with a dose
3. total self management: you do all of it

I travel a lot and I wanted total freedom. So I self manage totally. When I started out there was a lot to learn and I wanted as much data as possible as well as reading and asking on places like here.

Unless you are totally self managing your INR the graphs are pointless.

 

[njean]

Hello and welcome!

First off, don't let the notion that if you have to be on anticoagulants (blood thinners) for the rest of your life, keep you from making your choice of whether to go with a mechanical or tissue valve be the deal breaker.

I have been on Coumadin for 39 years and it all started out when I was 24 years old. I am 63 now and thankful to still be here! I never let Coumadin manage or dictate what I wanted to do with my life. I lived it to the fullest: camping, fishing, hiking, competition archery, biking and traveling. I never really watched my diet ..."watch out for the greens"
as you will hear time and time again! I ate sensibly and didn't do anything to access. I respected the fact that I was on this medication and took it as I was told and tested as required! For over 25 years I tested once a month at a hospital lab. I started testing weekly or bi-weekly about 8 years ago because I acquired my own monitor.

Another thing, do not let my signature throw you off when you see that I have had 3 OHS surgeries and am currently in need of a 4th one. The 2nd OHS was due to one of the valves becoming unsewn from some of the sutures (very rare happening) and the last one in 2006, was due to extreme scar tissue or pannus growth that had formed on the mechanical aortic valve (also rare).

That said, I wish you the very best with your upcoming surgery and hope that our posts help to reassure you that life doesn't end with OHS or anticoagulants.....it just opens up a brand new and beautiful horizon for you!

 

[neo]

Hey there. Before you make any decisions about your valve, make sure you are up on all the latest trends. This link is an excellent update on where everything is going. I think it may be much easier to make a decision once you read this. Good luck!

http://www.heart-valve-surgery.com/eBook-Advances-Aortic-Valve-Aneurysm-Surgery.pdf

 

[njean]

I don't think any of us are trying to make up your mind for you or make you believe that you MUST go mechanical! Valve choice is a very personal choice and you need to choose whatever valve you believe will work best for you. However, if the IDEA of having to be on 'blood thinners' for the rest of your life frightens you, then keep reading and find out for yourself how it's affected our lives.

Two years ago, my older brother found out he needed an aortic valve and he too was very torn between going mechanical or tissue. (He's 66 yrs. old.)

I told him the same thing: Educate yourself first on what both type valves can offer you and then make your choice. Both choices offered you an extended life so clearly, whether you go mechanical or tissue, it's better than not doing anything at all! In the end, he went mechanical and he also had to have a pacemaker put in at the same and he is doing just fine. He has his INR managed at the Coumadin Lab, eats healthy and stays very active.

 

[kcamarata]

You have all been a wealth of information. Thank you.

 

[joel1947]

Do you all really think the choice should be yours rather than your doctors? I am hoping for repair, and if that is not possible I want to optimize for the best gradient. I prefer a tissue valve and made that clear , but when my surgeon has me open and has a good look I expect he will decide what is best. If it is 50/50 I want a choice, but if not, I rather he decide. Am I crazy in thinking he knows better than I?

 

[dick0236]

Do you all really think the choice should be yours rather than your doctors? ....... I prefer a tissue valve and made that clear....... Am I crazy in thinking he knows better than I?

Personally, I believe that the surgeon, who IS the expert, will make the decision that is best under the circumstances.....but if it turns out to be "six of one and a half dozen of the other", he/she will, and should, consider your wishes. There are so many choices today, for valve types or procedures, that your doc should welcome your input as to what is important to you in your post-op world.

 

[river-wear]

I've talked to three surgeons now, and they all have their ideas. For them, multiple surgeries are all in a day's work so they may favor tissue and the patient may avoid warfarin. Others feel that younger patients should go mechanical because each surgery gets more complicated.

Of course your surgeon should do what's best for you, but I would argue that one facet of "what's best" may be your wishes regarding valve type. (Once he/she confirms that either type is suitable for your case.)

 

[njean]

Back in the day when I had my first surgery (1975), I don't even think tissue valves were available so it was all left up to my surgeon. That said, I have never regretted getting double-valve mechanical implants (Cooley-Cutter), which are obsolete now and are on display at the THI museum.

 

[neil]

interesting thoughts on here, but it all comes down to what you want, not what anybody else thinks you want, if i was gonna listen to anybody it would be the experts, thats the cardio and surgeons and even mine disagreed on choice lol,

 

[Aggie85]

You were asking lots of questions about the Wafarin and management. Be sure to look at the two forums specifically about those issues. Anti-coagulation forum and Home monitoring of ACT forum. WEALTH of information on those specific to that on there.

Good luck and know there are nowadays no WRONG decisions.

Linda

 

[pem]

Hi Pellicle - that's the spreadsheet I was looking for! Any way I can get it from you again? I think you were the one to originally provide it. Or just tell me the windowing model you use.
Thanks,
pem