I am having to have another AVR some time in the next few months as my first replacement valve now has severe regurgitation. My dilemma is whether to have another tissue valve or a mechanical one. I am 58 so know that if I have another tissue one there is a possibility I may need another op. However I had a splenectomy last year after it went rogue and started killing off my blood cells, cause unknown, so am at high risk of infections and have to take antibiotics daily. In addition I understand that warfarin can be affected by diet. I am not a 'meat and two veg' person and don't eat what could be considered a regular diet - I often have cereal for supper. Is anybody on warfarin who can tell me how they get on with it?