Who has bio valve and takes coumadin?

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I think the main point of the article is that AF is the most common cardiac disorder. I also think that when someone has had heart surgery and develops atrial fib then the treatment is almost always anticoagulation therapy.

If someone chooses a bio valve rather than a mechanical one then he should just know that there is still a significant risk of still ending up on coumadin. To many people it obviously is well worth the risk. I personally prefer being on coumadin than knowing I would have to eventually have another heart surgery. I guess if I knew I would get along fine until surgery was needed would be one thing but going through a period when I knew my valve was deteriorating and not functioning well just brings to my mind how bad I was feeling before surgery and I sure wouldn't want to go through that again. Anyway, it sure is nice to have a choice. Years ago we would have just been dead.
 
Statistic

Statistic

For those who use them:
The average person's(nonheart pt.) lifetime chance of AF is 1 in 6.
If your over forty, it is 1 in 4.
 
bvdr said:
but going through a period when I knew my valve was deteriorating and not functioning well just brings to my mind how bad I was feeling before surgery and I sure wouldn't want to go through that again.

That's me too Betty. I think our members who say they didn't really notice anything prior to being told they needed surgery are fortunate. I personally spent 6 years in continual decline prior to my surgery. Being 20 years ago when my problems started, they were very cautious in recommending surgery to someone as young as I was. Now, I'm certain they would not let me go on that long. But the experience of the decline of physical ability prior to surgery was enough to make me not want to repeat that.
 
Atrial Fib Stats

Atrial Fib Stats

My 34 year old husband went into "post op" atrial fib day 2 post aortic valve replacement with a mechanical. I was very upset by his going into a fib, but the surgeon, the fellow, and his cardiologist all told me the same thing;

40% of all post valve pts, bio and mechanical, go into post op atrial fib. Of those 40%, they feel 30% will not convert to a normal sinus rhythm on their own, chemically or electrically.
 
I personally had a Ross Procedure and am not on Coumadin

A had to take it for a very brief bought of arrhythmia's following my surgery (less than six weeks post op). Have not even considered it since. Other than the learning I do about it here at VR.

Take care all,

Ben
 
In the article Betty refers to, the over 30% incidence doesn't seem to be for continuous atrial fibrillation, but for episodes of Afib after valvular heart surgery, as it's in a paragraph that refers to the added hospital costs caused by bouts of Afib after surgeries. That would not be cause for long-term anticoagulation.

Numbers elsewhere in that article indicate that about 29% of those with mitral stenosis develop Afib, but only about 1% of those with aortic stenosis. It also notes that over 50% of those with Afib are over 80 years old. It is suggested that changes in the atria are associated with Afib, but it is undetermined whether they are causal or resultant. These numbers seem more in keeping with the experiential data that appears in the forums in posts.

It should also be noted that Plavix (an antiplatelet agent, like aspirin) is being increasingly used for continuing Afib, as well as for post-stroke ACT. Coumadin is no longer a lone wolf for Afib ACT.

However, Plavix (clopidigrel) is not being considered for mechanical valve act, as far as I am aware. Plavix has been out for quite a while. If its makers thought it would work with mechanical valves, I'm sure they'd have run trials for it by now.

Best wishes,
 
This is amazing.......

This is amazing.......

The post of mine I read today is not the post I sent to the forum.
How can this be............

I simply posted a dissagreement with Ross, in a manner that pointed out he can be very discouraging to the newbe's and to others.

Did this change in my post without my approval occur simply because I was dissagreeing with our moderator???
I think it did.

I believe I am not the only one who has had such an experience.

I am appalled by the change in my post and this may well cause my complete removal from this site. (Which I have been a member of since BEFORE it was a web page, and was just an e-mail ist)

Hank, I believe you need to look into this !!

A very angry, BEN
 
Ben see your PM's.

People please.....
What I posted to Mary and my subsequent posting to Kate served nothing more then to derail the train or hi jack the thread. I had no business posting it publicly and it should have been through private messaging. As a result, the thread started turning ugly and no longer about the subject. I deleted my posts and all quoted references to it to diffuse the situation and to bring the thread back on track. It has nothing to do with whether I agree with you or not, it was wrong, shouldn't have been here and was removed. There is no sense leaving my quoted posts up for further speculation. If they are not there, there is no reason for them to be showing as quotes either.

I don't know what else transpired here yesterday, but obviously something did. Not sure I want to know, but judging from what I've got in PM's and mail, it couldn't have been good.

We've been over this before. If there are grievances, take them to PM's and not posting on the public forum. All it does is serve to stir things up even further and this is what were trying to prevent to start with.


With that, lets keep the thread on track and hopefully drop this matter once and for all.
 
I don't know what took place but i know that Ross has a proven. good, track record here. If it were not for him, none of us would be posting anything here because Hank could not possibly handle all of it.

There will never be complete agreement. That is what keeps this site so lively. But lets have an agreement to disagree respectfully. Without that there will be a vast wasteland where there is now vitality.
 
It's important to separate temporary bouts of postsurgical atrial fibrillation from perseverent or repetitive afib. A large percentage of patients have bouts of afib right after OHS. And some postop afib patients require external conversion. However, the bulk of it is only temporarily, and happens a limited number of times from the initial insult of the surgery.

People are also commonly put on Coumadin or Plavix for three months after surgery for arrythmias and to avoid clotting from the healing tissue. It's the AHA/ACC standard treatment. The number of VRs who leave the hospital on Coumadin is not at all representative of the number who remain on life-long anticoagulation therapy. I have seen medical literature that doesn't delineate between long- and short-term ACT, and some of that may be reflected in numbers in soem posts.

As an example, I had afib for most of my second night after surgery (I converted on my own after about seven hours). However, it didn't happen again. I was already on a three-months Plavix course from the surgery to avoid clots, but was not changed over to warfarin. (In fact, the Plavix was even dropped at about six weeks.)

Another doctor might have put me on warfarin for six months, just to be sure. I would have been described as having been prescribed warfarin ACT for atrial fibrillation. However, it would not have been a lifetime journey.

Additionally, the difference between the afib effects of mitral and aortic valve replacement surgery are substantial. Those with mitral valve issues and MVR are deemed 29:1 more likely to develop afib by the article mentioned above. These figures are being mixed in our discussions. When referring to AVRs, those figures are inflated by 2800%.

And the over-80 age effect is startling. Half of all afib sufferers.

Is the risk of lifelong ACT there when you have tissue AVR? Yes. But it's quite a small risk. Is the risk there for tissue MVR? Definitely. Although it's still less than 1 in 3, it's substantial.

Does the risk increase with further surgeries? It would make sense to believe so. It's more insult to the heart. Then again, perhaps the percentage is actually less on the second surgeries, as most of those who were going to get it may have done so the first time around. Of couse, you're older by second surgery (hopefully), so that might affect your odds, too.

If you look at the makeup of the posting VR.com membership, you find that many linger to give and receive advice and information regarding warfarin use. Yet the number of tissue valvers who indicate that they personally are on ACT is minute. Most references to tissue valvers on ACT even in this thread are of the "I know a guy who..." variety. Not invalid, but, well, reaching.

I'm not at all pointing to that to say ACT with tissue is rare or doesn't exist, but to lend observable credibility to the numbers in the earlier-mentioned report. AVR 1%; MVR 29%; regardless of valve type. As far more MVRs are done with mechanical valves than tissue, the lack of a larger number of tissue-MVR-on-ACT responses would not seem out of kilter with those figures.

Just my opinion,
 
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