1) Decision of stopping warfarin would depend on two issues-: a) Type of valve-: if mechanical, warfarin has to be taken lifelong, if bio-prosthetic ~3 months it can be stopped B) If AF is persistent it will have to be taken lifelong, irrespective of the type of valve. Don’t stop it on your own, you will be at a very high risk for valve thrombosis, which is a very difficult condition to manage. 2) Aspirin is usually started in most valve replacements and has to be taken lifelong 3) Dose of Dilzem can be reduced, as it has to be rotated with HR and BP. You should meet your cardiologist/cardiac surgeon before starting/stopping any medication.