artificial aortic heart valve

[Emye343]

hi all,

After many hiccups, I have finally had my aortic valve replaced (just in time as it turned out…). Anyway, my surgeon is now saying that, because there is very little research into the effects of biologics on artificial heart valves, he doesn’t want me on ra meds for 3 months and, even then, he is not keen for me to go back on biologics. I was due to start Orencia after the op. I was wondering if anyone on here has experience of taking biologic meds whilst having an artificial heart valve (doesn’t have to be an aortic one!), and can reassure me? I can’t see myself managing without biologic meds as I have had reactions to all the dmards except hydroxychloroquine, which actually didn’t help much. Thanks in advance!

[bpeal1]

I don’t know the answer as I haven’t been in your situation. However, I would speak to your rheumatologist and suggest they speak to your surgeon and come up with a plan together.

Uncontrolled inflammation can cause heart issues which I’m sure wouldn’t be good for the replaced valves either. Think there needs to be some joined up thinking here between the two specialists.

[Emye343 in reply to bpeal1]

hi, I agree but I’ve a feeling that is going to be nigh on impossible to arrange: I live in Guernsey and the rheumatologist flies in occasionally from Southampton and only managed one email to the cardiothoracic surgeon in Manchester (private because no nhs here) before the surgery itself. A big downside of living here…

[Deeb1764]

I am going through heart diagnosis and my RA and Cardio consultant have said once they know the actual issue with the heart is if more than a heart murmur and weird beat then I will probably have to come off the biologic. I was not happy as been the only drug working for me so far but you only have one heart and a key need!

SO I am waiting to see as research shown my one Baritcitnib can cause serious issues with the heart.

[Emye343 in reply to Deeb1764]

hi Deeb,

I’d be interested to know what they discover. My rheumatologist found a heart murmur which led to the discovery of my bicuspid aortic valve (born with it) and apparently the ra made it stenotic more quickly. Oh the joys of ra….

[crazylady57]

Hello Emye343, I'm probably not the right person here, I'm on Orancia, I had 2 biologics before, both of which I had to come off. This one suits me though. Hydroxycloroquine didn't do much either, they took me off it. Trial and error I suppose. Good luck. I hope it works for you.

[Emye343]

thanks! I was looking forward to starting this new one….

[oldtimer2]

Having recently been in hospital the fear of the unknown (Imraldi, adalumimab) amongst the medics (and nurses) was obvious. They didn't want me to have my usual injection and advised me to contact my rheumatologist before restarting.

I think that you should get a firm opinion from the rheumatologist one way or other.

It seems to me on the basis of logical thinking, that you should avoid an increase in inflammation and that you should be on a biological treatment for your Rheumatoid Disease - which can affect your cardiovascular system just as it can your joints as it's an auto-immune condition..... but you need an expert opinion, not mine!

Nag until you get the advice you need!

[Emye343]

Thanks oldtimer,

I think you’re right - as you said, uncontrolled inflammation can also damage the heart. I hope to get an appointment through to see the rheumatologist quite soon and to get a clear answer and some informed advice.