Warfarin for Tissue Valves?

[davidfortune]

Ok - for as long as I've been hanging out here and using y'all as a research institution... (for which I'm tremendously grateful - I sincerely appreciate this community and all of you. I have learned a ridiculous amount about AVR, BAV, anti-coagulation, and heart surgery in general from all the posts and all of you! ).....

Anyway - I'm rambling - this is my first question posed to the group.

It is really just curiousity since I'm no longer afraid of ACT. I have been reading that the standard of care in the USA requires Coumadin for 3 months after AVR even with a tissue valve. How many of you tissue valvers were actually on Coumadin for a period of time after your surgery?

 

[Lynlw]

Justin got a gortex conduit w/ a bovine pulm valve in it and was only on baby aspirin for a month or so post op, now is on no meds, lyn

 

[JohnnyV_46]

I have a Bovine aortic valve and never a day of rat poison.....

 

[RCB]

Recommendation not requirement

Recommendation not requirement

I have been reading that the standard of care in the USA requires Coumadin for 3 months after AVR even with a tissue valve.

Doctors are smart enough not to fall in to a lawyers trap by authoring a document that states a "requirement". The word is rarely used- most often the word is "guideline", "recommendation" or "what is reasonable." As such, a doctor is pretty much free to due as he pleases, unless there is overwhelming clinical data to the contrary. In this case, 3 months of ACT after a tissue valve replacement the data is not conclusive, but the conservative position
(Otherwise known as CYA) recommends, but does not require it.

 

[cam4est]

I have not been on ACT after either valve replacement. One was homograph and the other porcine. However, I did get fussed at by Dr. Phillips(Mayo) for not continuing taking an 81mg aspirin since the porcine. My cardio here said i did not have to continue but she felt differently. Is this because she is an ACHD cardio? Karen

 

[Kate]

I had my aortic valve replaced at the Cleveland Clinic last September and, based on their research, they no longer recommend the 3 months of Coumadin after a bio valve. However, they do recommend aspirin for life because our risk for stoke, while no where near that for unmedicated mechanical valvers, is permanently increased. Unless you have some serious stomach problem that prevents it, it's hard for me to imagine why anyone would resist a baby aspirin a day if it could prevent such a potentially devastating side effect. Kate

 

[debster913]

Although my mitral valve was repaired, I was still put on coumadin for six weeks after surgery to prevent clots. I haven't heard much about anyone else being on coumadin after a valve repair.

 

[Ron S]

Warafin for Tissue Valves

Warafin for Tissue Valves

David,
After porcine AVR in 1999 I was on coumadin for approximately three months. Seems like a good conservative strategy, but it sounds like the state of the art may have changed since then.

Ron S

 

[LUVMyBirman]

There is also a slight chance of being placed in Coumadin indefinitely. This after replacement with a tissue valve and or repair. Various circumstances. Arrythmia (Afib), clots, stroke, etc. One of my deciding factors for going mechanical.

 

[OldManEmu]

No Warfarin

No Warfarin

After my porcine AVR 11/2004 I was on heprin injections post operation in hospital. I have only been on 100mg asprin daily since discharge.