Due valve replacement next week advise on what warfarin is like to manage

[Andrea52]

Hi I’m new to this group ,I’m having aortic valve replacement next week and am apprehensive on the use of warfarin ,debating which valve to go for I’m 52

[MichaelJH Heart Star]

Hello and welcome to the forum! Tens of thousands manage with warfarin year in year out. Occasionally it can be difficult but often this is caused by people not sticking to the rules, usually eating what they should not. Also many are now home monitoring instead of going for blood tests. Although valves are lasting longer it is not a life long solution at your age. I would recommend a mechanical valve to avoid going through it again in your seventies or maybe earlier.

[Andrea52 in reply to MichaelJH]

Thank you for your advice ,yes I’ve decided mechanical just hope op isn’t cancelled last minute

[Routemaster]

Hi!

My mother was on warfarin for years and the only time she had problems with her levels was when she decided to lose weight by switching from vegetables to salads. She went back to vegetables and all was fine!

My husband has also been on warfarin a long time and, touch wood, his levels are always very stable.

[Andrea52 in reply to Routemaster]

Thanks for your reply

[Lucybird]

I had an aortic valve replacement. I got the mechanical valve because it's meant to last longer, and there are less complications when it comes to having children (I had my operation when I'd just turned 30). The warfarin has been ok to manage. You have some dietary restrictions, but that hasn't had much of an impact for me because I don't tend to eat green leafy veg anyway, and I know it's ok to have a little. I also don't drink frequently so I've given up alcohol rather than just sticking to 2 units. At first I went to the hospital to get tested but not I test myself at home which is easier, the only problem is that I had to buy my own meter which cost about £350.

[Andrea52 in reply to Lucybird]

Thanks for your reply very reassuring

[Fredders]

I had a mechanical valve fitted for my AVR 18 months ago. I haven’t had any problem with getting my warfarin levels steady. I home test and am presently on 8 week tests, but occasionally do interim ones if I think I’ve eaten something that might affect it. Like Lucy says, there are some dietary restrictions, especially things that are high in vitamin K, such as green leafy vegetables, as it is the antidote to warfarin, but they will give you plenty of info and I’ve found it very easy to cope. I had a tissue valve fitted the first time, but it started to leak after a couple of years, resulting in a second AVR.

One other thing that people notice with mechanical valves is the ticking. I can only hear mine at night but find it very soothing and my husband can’t hear it at all.

Hope your op goes well.

Wendy

[Andrea52 in reply to Fredders]

This group is so reassuring thank you for your reply

[Gundoglady]

I'm 52, Had an avr and resection done nearly 7 years ago, been on warfarin ever since, I haven't really altered what I eat or drink, consistency is the key to balancing warfarin.

I think I'm on a relatively low dose to maintain my levels at 2-3 with a target of 2.5

I take 2mg X 3 days a week and 2.5mg x 4 days a week

I do a manual job, where I could cut myself, frequently have, but it's never an issue, I don't tend to bleed much X

I live my life the same way I always have, good luck with the operation X

[Fortepiano]

Lots of people have no complications with warfarin.

My husband was on warfarin for 14 years ( not for a valve problem but same 2.5 INR) . A majority of the time he had a very stable well- controlled INR but nevertheless during this period he did have three warfarin emergencies ( not associated with diet).

I did find the 'out of the blue' nature of these emergencies extremely stressful, and that (with the ticking!) decided me against a mechanical valve when I later needed aortic valve replacement. I also worried about the added danger of head injuries on warfarin with even an in-range INR.

I was 60 when I had my AVR, but do expect to need another operation one day in the future, which I view with equanimity since I was very well looked after first time round. Others will feel the opposite and want above alł to avoid re-operation.

It's a really personal decision: re-operation, or warfarin and ticking.

If you go for mechanical I would definitely home test weekly: the more time you spend in range, the less the risk. Home testing is also very useful if you are away from home, unwell, or starting a new medication. Don't feel you couldn't eat green veg - it's actually recommended to eat them consistently ( and they are very good for you)!

If you go for tissue, the new Inspiris valve is likely to last considerably longer than other tissue valves ( but there are no guarantees). However, it may not be available at your hospital.

Whatever you choose it will be a lot better than the valve you have now!

All the best

[Nic25]

Hi Andrea52. Good luck and hope it happens for you next week and you can move forwards - the wait and build-up I found almost worse than the op itself! I'm 50 and had an AVR before Christmas - all went smoothly and I'm very much on the mend. Personally I went for a tissue Inspiris valve. But everyone here is right - Warfarin is a big change but very manageable. I personally felt ok with taking a gamble on getting 10/15 years of not needing it (hopefully longer) before the replacement decision raised its head again. But it is a very personal decision and the main thing is to go with your gut and back yourself that you've made the right decision for you. Sure you have! As I say good luck - we're all here for you on this forum. If you want to chat more feel free to DM - as always happy to try and help others with the same decision I was wrestling with last summer! Nic