Living with a Mechanical Heart Valve: Click.Tick.Thump. Love It!

Support Group for Mechanical & Artificial Heart Valve Surgery & Using Warfarin

Had my discharge appointment with the surgical team 8 weeks ago and was put on 1.25mg of Bisoprolol(beta blocker) to reduce my heart rate which was around 100 at rest and higher on activity. I'm now back under the Cardiologist and have an appointment with him in December.
I started Cardiac Rehab which I think is called Phase 3. I have found it very good and get a lot out of it. The main attendees are elderly gentlemen who have had heart attacks/events. I appear to be the only "valve".
I am now driving locally and feeling stronger. I'm doing more around the house including cooking & shopping and more strenuous activity I do slowly.
I'm disappointed that my INR is volatile as I wanted to get on the self test programme sooner rather than later. I was on 7.5mg Warfarin but my INR came down from 3.0 to 2.4 so I'm now on 8mg Warfarin. I include some green veg high in Vit K daily as advised but otherwise a healthy diet - low fat meat, oily fish, nuts etc. I wondered if increase in activity could impact on the INR. I suppose it's still early days for it to settle to a consistant level.
I developed toothache 2 weeks ago and needed a filling. So had to address the "antibiotic before dental work" question earlier than I would have liked. My Surgeon was adamant that people with mechanical heart valves must have antibiotic prophylaxis (2g Amoxycillin) an hour before dental work where bleeding is likely such as root canal work & extractions. He says the 2008 Nice Guidance is in the process of being changed again due to Cardiac Surgeons disagreeing with them. I persuaded my GP & dentist to give me the antibiotic for a filling (which was unlikely to cause bleeding) but I did not want to take chances with a new & vulnerable heart valve that was bedding in. In my experience, dentists and GPs are not clear about the guidance but Cardiac Surgeons who deal with the results of endocarditis are clear. So we have to advocate for ourselves if we feel strongly about this.

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Comment by nic nic on November 25, 2012 at 8:42
Hi Janet
Great to hear you are doing so well 10 weeks post surgery!
Maybe i m lucky but my dentist (nhs) has called me in before surgery and did a full scan and check up. He also told me about having to take the antibiotics pill 1 hour prior to any dental work but he also told me that he would not risk any major dental work because of my valve. He advised me to use corsodil to kill any bacterias.
Best wishes
Nicolae
Comment by Madeleine M on November 9, 2012 at 20:39
My surgeon also says that antibiotic cover is necessary for dentistry. When I saw my dentist, I brought a copy of my discharge notes which says this, plus has details of my medications.

I really dislike this uncertainty, and am not prepared to take chances with my valve. I hope that the guidelines are changed very soon. I don't like asking my dentist to prescribe out of guidelines, but luckily for me, he is willing to follow my surgeon's instructions.
Comment by John French on November 8, 2012 at 21:57
Janet - I definitely found that increased activity resorted in my warfarin dose needing to go up to maintain the INR levels. When I started cardiac rehab my INR dropped and my dose went up by about 1 - 2 Mg. I also found the same when I went back to work.

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