Thank you to everyone who contributed and to those who offered good wishes.
It also surprised me how many people I know who know someone on Warfarin.
For those who asked, this is the latest situation.

There was a strong consensus that Warfarin is a serious intrusion upon your
lifestyle. As my GP put it, it is OK if all you are doing is sitting around,
not doing much, and taking your Warfarin, but not if you want to lead any
sort of active life. He also said he would have concerns about my liver,
given my previous history, if I were put on Warfarin. That was this morning
and only served to confirm the impression I had been getting from all other
sources. He also reinforced my view that there were likely to be significant
advances in cardiac medicine in the next 10-20 years, while Warfarin has not
been improved upon in the past 50 years. So, the result is that the
artificial valve is not an option I am prepared to consider.

Now I am waiting for an appointment with the surgeon, to see whether he
would be prepared to consider me for the Ross procedure, in which one of my
heart valves is used to replace the damaged aortic valve and the other valve
has the tissue replacement. It has the advantages that the aortic valve,
which is the most highly stressed, is a living valve that ought not to
deteriorate, the replacement valve should last longer in the alternative
position and replacing it is an easier operation. The downside is that it
adds about an hour to the operation, which increases the morbidity risk, and
I am borderline for the age at which it is usually carried out. I hope to
find out whether that is down to the accountants at NICE, because there are
good clinical reasons not to, or whether the concern is about older patient
survival rate. At least I am fairly fit and have excellent lung function,
which should help with the last.

One advantage of swine flu; heart operations are being moved to an adjacent
private hospital, still on the NHS and with the same surgical team. That
should both free up ITU beds in the main hospital and avoid the possibility
of exposing recovering heart patients to the disease, which I had been
wondering about. They are currently looking at booking me in around mid to
late August, subject to what the surgeon says. I'll post an update when I
know that.

Thanks to all

Colin Bignell