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Studies have found that people who don't eat as much meat don't metabolize L-carnitine as well, but those who eat a lot of it have tons of the bacteria that turn it into TMAO

Dec 2012;11(4):293-303

Do not purchase if the outer seal is broken or damaged

In summary, the accumulation of TMAO will not only increase oxidative stress and endothelial cell damage and permeability but also lead to an increase endothelial-derived NOS expression ( Vascular Calcification: TMAO Activates the NLRP3 Inflammasome and NF-B Signaling Pathway in Vascular Smooth Muscle Cells (VSMCs) Vascular calcification (VC) is a phenomenon of disseminated deposition of mineral content within the medial layer of arteries

Still, both procedures require heavy anesthesia, both have incisions located in the same area, and both demand a longer recovery period when compared to many other surgeries