Firstly thank you to all those who replied to my original post. I have just seen the surgeon who has indicated short of saying it that I should have a bypass and a mechanical valve. Quoting the better option to prolong life and limit further procedures in the future.
The stent consultant feels he could do stents and that’s his recommendation leaving the valve for a later date.
This is all great but still leaves me with the original dilemma. One minute I’m leaning to stents next minute it’s a bypass.
I am now minded to go for the bypass but I will need to be on Wulferin permanently.
It would be good to hear your thoughts.
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Bubbler99
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I remember your first post and when I started reading this one I thought she has more or less been given the answer then I carried on reading and saw what was said about stents and thought what are they doing to this lady
Obviously no one can make this decision for you but if it were me I would go for the Bypass option I think it would be a better guarantee nothing further was needed later as for me that would always be in the back of my mind when will I need a new valve
So many take Warfarin on here and they seem fine and I am sure they will come along when they read your post and share their experiences with you
Thank you for the update and please let us know what you decide and how you get on x
A difficult decision for you. For most of us on this forum, we generally only have our own personal experience. Perhaps you could discuss your choices with your GP, who I expect will have knowledge of a number of patient’s outcomes as well as more awareness of your own medical condition. If waiting lists to talk to your GP are long, a telephone appointment might be an option. Hope that helps.
I had a bypass and a mechanical valve at the same time and have been on warfarin ever since. That was twenty years ago last week! It's not a big deal once you get the hang of it. Keeps me alive!☺️
Wow. that is truly a textbook dilemma. Given the gravity of the situation, could you ask for another cardiologist to review your file?
My own experience with stents: first round of 2 in the LAD did not accomplish much, as I had a HA 8 months later (different artery!). The second round of 2 were put in after the heart attack...bypass not offered as an option but I fully expect to be facing one at some point...
I’ve had both in the space of 3 weeks. I’ve got a bovine valve, taking a blood thinner for one year only because of the stents. I’m on Ticagrelor. Getting bruises everywhere with no idea how.
I’m also on soluble aspirin, that will be for life. NO warfarin needed. I am on other drugs as well to control my blood pressure as well as a beta-blocker and statin.
I was told, at 70, that the valve should last at least 20 years before they replace it.
I’ve also been told by the hospital that a mechanical valve can be noisy. Seen reports from some who have them that they can be heard by others in a quiet room.
Before you have open heart surgery there's a legal requirement for "informed consent". The "informed" part means you have to be made aware of the risks that the operation entails, so in the UK you'll be told there's a 2% chance of a bad outcome, such as a stroke or death during surgery.
The other way of looking at 2% is of course to say there's a 98% chance of success.
But we shouldn't get too cavalier about open heart surgery, unless you've led an exceptionally adventurous life a 2% risk is by far the most dangerous thing you've ever done. You would have to climb Mount Everest three times to rack up a similar 2% risk.
Furthermore, that 2% risk is an average, depending on age and co-morbidities it might actually be anywhere in the approximate range 0.2% to 20%. What is also clear from the statistics is that with each additional incidence of open heart surgery the additional risk only ever increases. So you really want to minimise the number of times you have it.
Having one open heart operation for a valve replacement then repeating it a year or two later for a bypass wouldn't be smart planning.
If you're mathematically or statistically minded you can find all the details regarding heart surgery risks in the EuroSCORE II documentation (it's all public domain). Or you can read a fascinating book by the British heart surgeon Samer Nashef, "The Naked Surgeon", who was one of the pioneers of the EuroSCORE quantified approach to surgical decision making.
But on the other hand there's the benefits.
I had bypass surgery five years ago and it's been absolutely transformational, I feel ten or twenty years younger and the past five years have been amongst the most rewarding and enjoyable of my life. For me it was a gamble that paid off in trumps and I'm eternally grateful to all the talented, dedicated people who made it possible. Faced with the same choice today I wouldn't hesitate, yes the risks are sobering, but the rewards can be little short of miraculous!
Whatever your choice I wish you a positive outcome. Good luck!
From the way you've worded it , it sounds like the bypass is the option that they know will have the best outcome.
I'd have thought if they were very confident with the option of stents they would have both pushed for that as your first choice, they usually do.
Even though it's more invasive , if I was making the choice I would be inclined to go for the bypass option, but you need to go with what you feel most confident in.
Let's us know what you decide and please keep updating us on your progress , or just pop on and post if you feel you need a chat, take care , Bee
I had the choice of a triple bypass or stents and went with the surgeon's recommendation for me having the bypass. I have not regretted it. Getting it done while you are relatively young and healthy is best. Personally I wouldn't wait for things to go downhill. I had had two stents in one artery when I had my heart attack (11 months before my op) and these were bypassed as part of the op, which I think says a lot.
It looks like you will need the valve replacement at some stage, so it is just a case of when. I can certainly see the logic of having it done at the time of the bypass.
Definitely go for bypass and valve. It’s more investment up front in terms of recovery, but all the data and research is showing that your long-term outlook is better going that route. “We can give you a permanent fix.” , is how it was put to me.
The procedure and recovery is actually nothing like what I expected. Routine, and you’ll be feeling so much better within a very few weeks.
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