Husband’s HALT on his bionic aortic valve(hypoattenuated leaflet thickening) is no more. Yesterday was the full year follow up with ultrasound and, after 12 months on double oral anticoagulation (Eliquis plus the baby aspirin he was already taking since his surgery), the valve looked normal, moved normally, and functioned normally (no regurgitation). Yay!
Decision moving forward …keep taking the tablets but 6 monthly follow ups for the foreseeable future. Per the intervention cardiologist, this is a pretty data poor area for evidence based decision making. About a 10-12% failure rate for these bio valves with no absolute concensus on cause. His feeling is that a good many are likely to be late forming clots, like my husband’s…that are only going to be spotted if looked for. Hence the frequent follow up visits with CT angiography every year.
Not much to say after all the superlatives around the function of the valve. So we talked about me for a bit (and the problems caused by population based vs patient orientated care) then his dog (who’s going to see my daughter in a week or two) then my daughter and the divorce. Then we came home.
I honestly don’t know, Wendy. This was the follow up protocol announced after dh’s surgery…and, remember, he had the Full Monty with coronary artery dissection too. He was on Warfarin for the first 3 months … which is also different from you, correct. I think he’d be willing to drop that if it had been the only option moving forward. Cheap enough…but a pain with the frequent INR checks and whatnot.
My husband decided for himself before the appointment that he’d choose to stay on the Eliquis. Whatever conditions were there to cause the clot to form are probably still there now so he isn’t inclined to risk a repeat. There’s more evidence in hepatology for continued use of this double anticoagulant protocol and he mentioned to the cardiologist yesterday that, while he was hors de combat after the initial surgery, the young locum they roped in to manage his ongoing cases, took three patients off the anticoagulant therapy dh had them on, and two had thrombosis recur in their portal vein by the time he was back at work 6 weeks later (going directly there from rehab, the fool🙄)