Megan
Well-known member
im still thinking about which valve to choose- my surgeon recommends the ats -or st jude. did anoyone here decide ats over st jude personnaly and if so why so? thanks!
ATS vs ONX or ST JUDE
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ALCapshaw2
Well-known member
Here is a copy of a post I wrote on Dec. 30, 2008 comparing On-X and St. Jude Mechanical Valves.
You may want to show your surgeon the Morbid Event Rate Date from below (or get the complete data table from On-X (888-339-8000 ext 265) or e-mail [email protected]
QUOTE:
The St. Jude Master's Series Valves have been around for 30 years and counting so they are 'Good Valves'. (I have one). I just happen to think that the On-X is a 'Better Valve' in several areas:
Reduced Risk of Clot Formation because of:
1- Reduced Turbulence due to full 90 degree opening
(vs. 75 to 85 degree openings for older valve designs)
2- Harder, Smoother (patented) evolution of the Pyrolytic Carbon material in the leaflets (Designed by Jack Bokros, Ph.D., who also designed the leaflets in St. Jude, ATS, and Carbomedics and holds several Patents)
3- Improved (smoother) Valve Pivots
Less Damage to Red Blood Cells (Hemolysis)
- equivalent to levels in Tissue Valves, about 1/2 the level in older mechanical valves.
ONLY Valve that has a built-in Barrier to Pannus Tissue Growth which is the Major Factor in Mechanical Valve Explantation (i.e. Removal and Replacement) - This is a Low (but NOT Zero) Risk condition that has been reported on VR.com for both Mechanical and Tissue Valves.
Anti-Coagulation with Coumadin / Warfarin gets around the Clotting Issue (for the most part) *as long as INR is In-Range*.
The BIG ISSUE and Difference is when it is necessary to go OFF Anti-Coagulation for Invasive Procedures.
OLDER Mechanical Valves are Known to cause Clot Formation after ?? days when going OFF Coumadin.
Experience with the On-X Valves in Africa with a substantial population of Non-Compliant recipients shows greatly reduced risk of Stroke compared with the older Mechanical Valve Designs in patients whose INR is NOT in
Range (ask On-X for a copy of the Study).
FYI, the On-X Valves were introduced to the World Market in 1996 (12 Years ago) and there are over 70,000 On-X Valves in use around the World (in 64 Countries).
Yes, It's the "New Kid on the Block", but it's no longer in 'childhood' (as many in the Medical Field seem to think).
It comes down to answering the Question:
Do you want the latest improvements in technology with a 12 year track record or,
Do you want a Valve that has been around for 30 years with good results?
BTW, the St. Jude REGENT Valve (for the Aortic Positon ONLY) was introduced in 1999(?), AFTER the On-X valve came onto market. It would be interesting to know how many have been implanted. There was a report on surgical experiences with this valve in a Medical Journal a few years ago. (I'll have to look up the reference).
MY preference would be On-X as First Choice
with the St. Jude Master's Series as Second Choice.
'AL Capshaw'
Disclaimer: I am NOT a Medical Professional, merely an interested Heart Valve Patient. The above is a summary of my 'understanding' and is my non-professional *opinion*.
END QUOTE
=======
The following is a comparison of Morbid Event Rates for Mechanical Valves which I copied from a Table that was included in an "Information Package" from On-X.
From www.ValveReplacement.com - Valve Selection Forum - January 2009 - Thread Title: "St Jude"
QUOTE
A few years ago, On-X sent me an 'Information Package' which included a pair of tables entitled "Morbid Event Rates Comparison" for both the Aortic and Mitral positions with footnotes indicating the source of the data for each company which included PMA (something about Safety and Effectiveness) Summaries (ATS and CMI) and FDA submissions.
The combined rates in (% per pt-year) for Thromboembolism, Thrombosis, and Hemorrhage for the
Aortic Position were
On-X = 2.14 % per pt-year
SJM = 3.90 St. Jude Medical
CMI = 2.96 Carbomedics
ATS = 4.04 ATS
MH = 2.50 Medtronic Hall (I believe that is a single leaflet valve)
Mitral Position
On-X = 1.86 % per pt-year
SJM = 3.34
CMI = 4.44
ATS = 5.07
MH = 4.30
I left off the breakdowns by categories because I'm not about to sit here and re-type all that data. Note that other factors such as Hemolysis (blood cell damage) and Pannus Tissue Growth are not even included in the above statistics.
The complete charts are available to ANYONE who asks for them. Just call or e-mail On-X and they will send you whatever information you request. Contact information is on their website www.onxvalves.com or 888-339-8000.
They have recently published another set of Bar Graphs which also include several tissue valves (which I find a little hard to interpret - too much information in too little space... give me the numbers in a spread sheet format please).
'AL Capshaw'
END QUOTE
========
You may want to show your surgeon the Morbid Event Rate Date from below (or get the complete data table from On-X (888-339-8000 ext 265) or e-mail [email protected]
QUOTE:
The St. Jude Master's Series Valves have been around for 30 years and counting so they are 'Good Valves'. (I have one). I just happen to think that the On-X is a 'Better Valve' in several areas:
Reduced Risk of Clot Formation because of:
1- Reduced Turbulence due to full 90 degree opening
(vs. 75 to 85 degree openings for older valve designs)
2- Harder, Smoother (patented) evolution of the Pyrolytic Carbon material in the leaflets (Designed by Jack Bokros, Ph.D., who also designed the leaflets in St. Jude, ATS, and Carbomedics and holds several Patents)
3- Improved (smoother) Valve Pivots
Less Damage to Red Blood Cells (Hemolysis)
- equivalent to levels in Tissue Valves, about 1/2 the level in older mechanical valves.
ONLY Valve that has a built-in Barrier to Pannus Tissue Growth which is the Major Factor in Mechanical Valve Explantation (i.e. Removal and Replacement) - This is a Low (but NOT Zero) Risk condition that has been reported on VR.com for both Mechanical and Tissue Valves.
Anti-Coagulation with Coumadin / Warfarin gets around the Clotting Issue (for the most part) *as long as INR is In-Range*.
The BIG ISSUE and Difference is when it is necessary to go OFF Anti-Coagulation for Invasive Procedures.
OLDER Mechanical Valves are Known to cause Clot Formation after ?? days when going OFF Coumadin.
Experience with the On-X Valves in Africa with a substantial population of Non-Compliant recipients shows greatly reduced risk of Stroke compared with the older Mechanical Valve Designs in patients whose INR is NOT in
Range (ask On-X for a copy of the Study).
FYI, the On-X Valves were introduced to the World Market in 1996 (12 Years ago) and there are over 70,000 On-X Valves in use around the World (in 64 Countries).
Yes, It's the "New Kid on the Block", but it's no longer in 'childhood' (as many in the Medical Field seem to think).
It comes down to answering the Question:
Do you want the latest improvements in technology with a 12 year track record or,
Do you want a Valve that has been around for 30 years with good results?
BTW, the St. Jude REGENT Valve (for the Aortic Positon ONLY) was introduced in 1999(?), AFTER the On-X valve came onto market. It would be interesting to know how many have been implanted. There was a report on surgical experiences with this valve in a Medical Journal a few years ago. (I'll have to look up the reference).
MY preference would be On-X as First Choice
with the St. Jude Master's Series as Second Choice.
'AL Capshaw'
Disclaimer: I am NOT a Medical Professional, merely an interested Heart Valve Patient. The above is a summary of my 'understanding' and is my non-professional *opinion*.
END QUOTE
=======
The following is a comparison of Morbid Event Rates for Mechanical Valves which I copied from a Table that was included in an "Information Package" from On-X.
From www.ValveReplacement.com - Valve Selection Forum - January 2009 - Thread Title: "St Jude"
QUOTE
A few years ago, On-X sent me an 'Information Package' which included a pair of tables entitled "Morbid Event Rates Comparison" for both the Aortic and Mitral positions with footnotes indicating the source of the data for each company which included PMA (something about Safety and Effectiveness) Summaries (ATS and CMI) and FDA submissions.
The combined rates in (% per pt-year) for Thromboembolism, Thrombosis, and Hemorrhage for the
Aortic Position were
On-X = 2.14 % per pt-year
SJM = 3.90 St. Jude Medical
CMI = 2.96 Carbomedics
ATS = 4.04 ATS
MH = 2.50 Medtronic Hall (I believe that is a single leaflet valve)
Mitral Position
On-X = 1.86 % per pt-year
SJM = 3.34
CMI = 4.44
ATS = 5.07
MH = 4.30
I left off the breakdowns by categories because I'm not about to sit here and re-type all that data. Note that other factors such as Hemolysis (blood cell damage) and Pannus Tissue Growth are not even included in the above statistics.
The complete charts are available to ANYONE who asks for them. Just call or e-mail On-X and they will send you whatever information you request. Contact information is on their website www.onxvalves.com or 888-339-8000.
They have recently published another set of Bar Graphs which also include several tissue valves (which I find a little hard to interpret - too much information in too little space... give me the numbers in a spread sheet format please).
'AL Capshaw'
END QUOTE
========
Marty
Well-known member
Dr. Puskas chief of heart surgery at Emory who is conducting the PROACT study to see if ON-X valvers can live without warfarin. ( won't be finished for another few years) , shared with me in a personal non-official E-mail that ON-X currently is looking like the best valve.
I have a St. Jude because at that time ten years ago my surgeon thought that was the best valve.
I have a St. Jude because at that time ten years ago my surgeon thought that was the best valve.
I am currently trying to make the decision about valve type also, am leaning
more and more towards the On-X. Thanks Marty for sharing this info.
it helps us who are trying to make the right decision individually to hear
how different professionals are looking at these valves. Laura
ALCapshaw2
Well-known member
Laura,
Since you are interested in Professional Opinions of the valves, you may want to do a Search for Dr. Pettersson at Cleveland Clinic. He has the most experience with the On-X Valve at CC. I recall one of our members reported that he asked Dr. Pettersson which valve he would choose if he needed a Valve Replacement. I believe his answer was On-X. You can check it out for yourself. The comment is somewhere in the archives. (Edit - See post below from CtyGuy who confirms this statement - he was the one who asked)
Alternatively, you could call or write him for his opinion.
You won't find a more qualified surgeon in the country IMO.
On the matter of Lower / NO Anti-Coagulation with the On-X valves, since I am already on Coumadin, I'm not terribly concerned with that outcome. The Big Deal about that study is that the Reason it is even being studied in the first place is that the On-X valve has the LOWEST Propensity for Clot Formation of any Mechanical Valve on the market. You don't see any others even being considered. ONE company did make a similar claim many years ago and a study was started (in France if I remember correctly). From what I was told, the study was STOPPED because of so many Early Failures!
On-X can direct you (or anyone) to a report of that study.
sue943
Well-known member
My cardiac surgeon selected my valves for me and chose ATS. Since the cost wasn't a factor as I had private health insurance which would pay 100% of the costs he presumably thinks the ATS valves are good. I had told him that noise was a factor for me so perhaps that also helped him to select ATS as they are quiet.
ctyguy
Well-known member
Laura...
I had my Aortic valve replace with an On-X by Dr Pettersson at C.C. I was the person who ask Dr P what valve he would want if he were having the procedure and he did indeed say he would choose an On-X.
My procedure was 14 months ago and I have no regrets with my choice. I honestly didn't give alot thought to valve choice but I only had 2 weeks from diagnosis to my procedure. When I started my research I saw that the On-X was being chatted up as the latest and greatest but my focus wasn't the valve but the surgeon who was going to do the procedure. I knew I wanted to go to C.C. and Dr Pettersson was my first choice given his reputation and experience. The fact that he said On-X if he were in my shoes sealed the deal for me.
And as a result of the procedure I have gone from not being able to run for more than 1 to 2 minutes without SOB or chest pains to running a 1/2 marathon (my first ever) last weekend. It still floors me as to what can be done medically to help people with these types of conditions.
Best of luck to you !
I had my Aortic valve replace with an On-X by Dr Pettersson at C.C. I was the person who ask Dr P what valve he would want if he were having the procedure and he did indeed say he would choose an On-X.
My procedure was 14 months ago and I have no regrets with my choice. I honestly didn't give alot thought to valve choice but I only had 2 weeks from diagnosis to my procedure. When I started my research I saw that the On-X was being chatted up as the latest and greatest but my focus wasn't the valve but the surgeon who was going to do the procedure. I knew I wanted to go to C.C. and Dr Pettersson was my first choice given his reputation and experience. The fact that he said On-X if he were in my shoes sealed the deal for me.
And as a result of the procedure I have gone from not being able to run for more than 1 to 2 minutes without SOB or chest pains to running a 1/2 marathon (my first ever) last weekend. It still floors me as to what can be done medically to help people with these types of conditions.
Best of luck to you !
I have an ATS aortic valve. I was never asked , or told there was another "out there". I didn't have time to look anything up, as I was rushed in for the operation. It works for me, thats the only thing I care about. They say it will out last me.
sue943
Well-known member
Those echo my sentiments exactly.
From the number of people here who have had mechanical valves replaced from time to time for some reason or other it looks to me that it really doesn't make a whole lot of difference one way or another. All I know is that mine are working just fine after almost four years, they are quiet and don't keep me awake at night and no one has ever heard them without sticking their head on my chest. That works for me.
Kvntoday
Active member
Hi Ken,
I too have an ATS which I fine quiet but I do hear it at night as I am permaent A/fib because of a failed Maze procedure.
I researched the company here in New Zealand and they sent me testimonials of the ATS valve and its Attributes , they assured me that the ATS is fitted world wide with Total success .
I was not given a choice of what brand of valve and since my OP 3 years ago the surgeon has not contacted me at all and seems totally uninterested?
Once they have got your money they lose interest .
Kevin
I too have an ATS which I fine quiet but I do hear it at night as I am permaent A/fib because of a failed Maze procedure.
I researched the company here in New Zealand and they sent me testimonials of the ATS valve and its Attributes , they assured me that the ATS is fitted world wide with Total success .
I was not given a choice of what brand of valve and since my OP 3 years ago the surgeon has not contacted me at all and seems totally uninterested?
Once they have got your money they lose interest .
Kevin
ALCapshaw2
Well-known member
Kevin,
I think your last comment is a bit harsh towards surgeons.
Their job is to FIX your heart, verify that their Fix is working, and go on to help the next patient. Most surgeons only have one or two followup visits with patients and then never see them again unless/until another surgical need presents itself.
Continuing Heart Care falls unto the responsibility of your Cardiologist and/or Primary Care Physician. That's just how it works, all over the world.
'AL Capshaw'
My husband has the ATS aortic valve. His surgeon was Dr. Puskas at Emory. I don't think the On-X had been around long at the time of his surgery nearly 8 years ago. I do know Dr. Puskas is a great surgeon and I would go with whatever he recommeded.
Megan
Well-known member
Thanks everyone. so after reading your comments i decided i needed another opinion form another surgeon . so i did that and the surgeon recommended the ats valve for me because i am vbery sensitive to sound. I brought up the on-x study and he said a healthy dose of skepticism is always good when you see a study that is favorable to the company- you have to ask who paid for the study ...he said if you keep your inr steady then the on-x and ats and st jude are all basically the same... he also said that a flaw tothe study is that its difficult to say what the inr levels were of the people inlcuded in the study so the #s may not be entirely right... it makes sense. I did call on-x- cburnett..to see if i could find out but i just havent connected yet... all the same, im feeling comfortable witht he ats valve as my selection. thanks again!
