GP wants to stop my aspirin a year after TAVR because of a stomach scare. Cardiology letter says lifelong. Who do I listen to?

#1TwoNightsTerry(Joined Feb 2026 · 63 posts)September 3, 2026, 5:48 pm

Bit of a mess this and I would value hearing from anyone who has been through similar. TAVR last autumn, sailed through it, one aspirin a day ever since and honestly I had stopped thinking about it. Then last month I had a week of black stools, went to the GP, got sent for a camera test, and they found an irritated patch in the stomach lining. Not bleeding badly they said, but bleeding.

The GP's view is that at 76 with a stomach like that I should come off the aspirin altogether, and she said it quite firmly. But I have the letter from the valve clinic from my follow up and it says in black and white "continue single antiplatelet lifelong". So one doctor says stop, one piece of paper says never stop, and I am sat in the middle with a box of tablets not knowing whether to take tomorrow's one.

What I really want to know is this. If I DO stop it, is the valve suddenly at risk? Is a year long enough that the thing has "bedded in"? And is aspirin actually the same sort of business as warfarin, because my brother in law is on warfarin for a metal valve and his stories are what have me frightened.

#2frankm1952(Joined Apr 2026 · 19 posts)September 4, 2026, 9:12 am

Not the same as warfarin, no. I had exactly that muddle in my head for the first month after mine. Aspirin does not need the blood tests and the diet business, that is the warfarin lot. But I would not decide anything off this board Terry, ring the valve clinic and tell them what the GP said. That is what they are there for.

#3Marlene K(Joined Mar 2026 · 31 posts)September 5, 2026, 2:30 pm

Terry I had a version of this with a different drug. I was on two antiplatelets after mine and bruising like a peach, and my GP and my cardiologist disagreed about whether to drop the second one early. What sorted it was not me picking a side, it was the GP writing directly to the valve clinic and the two of them agreeing a plan between themselves. Took about ten days. I took the tablets as prescribed until they came back with a joint answer.

The worst thing I could have done was quietly stop on my own, which I was very tempted to do.

#4Dr. Helena VossClinical reviewer(Joined Jan 2026 · 58 posts)September 8, 2026, 11:05 am

TwoNightsTerry said:

If I DO stop it, is the valve suddenly at risk?

Terry, the direct answer is that this is not a choice between two doctors, it is a decision that needs both of them talking to each other, and the safe position while that happens is the one Marlene describes: keep taking what you are currently prescribed until the people responsible for your valve and your stomach have agreed a plan. Please do not stop on your own, and please do not double up either.

On the substance. Guidance after TAVR for someone with no other reason to be anticoagulated is a single antiplatelet, usually low dose aspirin, continued long term, and that is what your clinic letter reflects. But "long term" in a guideline is a default for the average patient, not an instruction that overrides a bleeding problem. A documented gastrointestinal bleed on aspirin is precisely the kind of thing that can change the balance, and it is a common reason for a cardiologist to review whether the tablet continues, changes to a different antiplatelet, or is given alongside a stomach protecting medicine. A year out, the valve frame has largely been covered by your own lining, so the clotting risk from the device itself is lower than it was in the first months, which is one of the things your cardiologist will weigh. That is a reason the conversation is reasonable to have, not a reason to skip the conversation.

Frank is right that aspirin and warfarin are different things. Aspirin is an antiplatelet; it stops platelets clumping on a surface. Warfarin is an anticoagulant; it slows the clotting proteins and is what a mechanical valve like your brother in law's needs for life, with monitoring. A TAVR valve is a tissue valve and does not need warfarin. The difference, and what happens when atrial fibrillation or a bleed changes the plan, is set out in blood thinners after TAVR, which is worth reading before your clinic call so the vocabulary is familiar.

The practical step is the one Marlene took: ask your GP to write to the valve clinic, or ring the clinic yourself and tell them about the bleed and the camera result. Black stools on any blood thinner is something the heart team wants to know about regardless of who decides what. Whether your aspirin stops, changes or continues with cover is for your own cardiologist, with your endoscopy report in front of them, and I would not want you taking a general answer from me in place of that.

#5Edith R(Joined May 2026 · 12 posts)September 11, 2026, 4:22 pm

Terry, reading this from the waiting side. I have just added "which tablets, for how long, and written down" to my list for the planning appointment, because it had not occurred to me that a year on there could still be a question about it. And one thing nobody has said: if you do come off it, ask them to write down what symptoms would mean you ring back, so you are not jumping at every twinge.

#6TwoNightsTerry(Joined Feb 2026 · 63 posts)September 18, 2026, 7:40 pm

Update for whoever finds this later. GP wrote to the valve clinic like Marlene said. Clinic rang me on Tuesday, went through the endoscopy report, and the upshot is I stay on the aspirin but with a stomach tablet added, repeat camera in a few months, and a review then. So neither "stop" nor "never change", a third thing I had not thought of.

Kept taking it throughout, felt like the right call. Thank you Dr Voss and all. Brother in law has been told to stop scaring me with warfarin stories.