Choosing either the On-X or St. Jude Regent...opinions?

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Al...you are 100 percent correct....artery inserted valves are tissue and can only be implanted inside the existing ring of another tissue valve......the expected longevity of only 5 years is the disappointing aspect. If it was good for another 10-15 years it would make tissue valves a very attractive option for younger people...Mike

I have been following the percutaneous valve replacements for a while, there are alot of really good videos from the past couple AATS conferences by the surgeons that have been doing them, and You can watch them online, they have quite a bit of info on how many patients get them, the success rate, failure rate how they are doing so far ect this is where many of the other doctors not involved in the trials learn about them and some of the seession you can even listen to the Q&A following thepresentations. . They currently are doing the aortic valve (Sapien) trials in the US for them too, the Pulmonary valve (melody) has already gotten FDA approval. I've talked to doctors at Boston Childrens and CHOP/U of P that (UofP is part of the Sapien trials) about both valves and I have NOT heard the Aortic are only lasting 5 years. I believe they have only been doing them about 5 years, maybe thats what they meant? The pulmonary valves (which for the most part are going in kids/young adults who are very active) have been around about 10 years. They have already replaced percutaneous pulmonary valves, with new percutaneous valves but most are still going strong. Part of the reason, in the US at least, they are only being used in older people who are not candidates for OHS is prettty much because it is a trial and often when there already is a medical procedure with good results, acceptable morbidity/mortality, theydo trials on patients that could not survive the normal procedure and with out the trial would not survive long. The pulmonary valves didn't have the same criteria, mainly because the people that need pulmonaryvalve replacements are kids/adults with CHD and already had 1 or more surgery as a baby/child.
 
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To the best of my knowledge the catheter placed valves are TISSUE and they can only be placed inside either your native (tissue) valve or a prosthetic tissue valve. It is my understanding that a Mechanical Valve must be removed by normal surgery before another valve can be implanted.

'AL C'

Al,
What you stated is exactly what I was told by the surgeon re: my aortic valve. My surgeon also felt that when (or if) the times comes to replace my pulmonary valve it will be the percutaneous procedure. I hope he is right :)
Thanks for the update on the pulmonary valve procedures, Lyn.
 
I fear for all of you pinning hopes on what might be in the future.

I don't know of anyone pinning their hopes on it, most i know, plan on needing another surgery, ( for the aortic anyway) but being able to avoid with with percutaneous replacement would be even better. The next couple years will be interesting. Just like the people choosing mechanical now, depending what valve they get plan on a life time of coumadin, but if that changes and they don't need it in the future that would be better. Altho IF (and that is a big IF) things keep progressing like they are, chances are percutaneous valves for the Aorta will most likely be approved in a couple years.
Pulmonary is a different thing since it is already approved and if you meet the criteria (need the right size available valves) if you are willing to travel to the places doing them, you can have one now.
 
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Oh my God Bina, I can't believe you said that! Or, I mean thought it , and didn't say it ;) ...............
I can't believe that slipped past me!
Ross has trained me well. :wink2:

Well, goodness, I think I am speechless, too!
Andy, I don't know how to tell you this but mine is bigger than yours, and so is Bina's and we're girls.
Hmmm..maybe we aren't really girls? :confused2:

Haha, mines bigger then yours is and believe it or not, they've mentioned a possible mismatch from my echo report. I have a 25mm.
25mm :eek2: Wow. Now I really am speechless. :biggrin2:
 
Well i am 3 days out from surgery for AVR and yesterday went thru all my final pre op tests.....I was also told that i actually have till the morning of the surgery to discuss and decide with the surgeon what kind of Valve i prefer. I have a question for all of you with a mechanical valve and on coumadin. Do you find that the coumadin makes you feel cold? I have had several friends on the drug tell me that they always feel they are chilly. Just curious if this is a very common side affect. Thanks all :)
 
I've always "run hot" (mostly from being overweight I think) but no, I haven't noticed feeling cold while on Coumadin. I hadn't heard of that side effect before so haven't been paying attention, but will try to pay more attention next couple days just to make sure. I do remember getting cold in the hospital a couple times and asked for extra blankets, but I think that's just cause it was so damn cold in those rooms, esp. at night.
 
I tend to run on the warm side, too, though I was mostly cold for about a month or 2 after surgery. I think it's due to bringing down your body temp during surgery. I rarely turn the heat on at home and this winter had it on a lot. I'm fine now.
 
Best wishes for a very smooth surgery and recovery Heartman. Let us know if any other last minute questions before the big day, and give us an update when you feel up to it on the other side. And don't forget to clip your toenails ;)
 
I've always been hot-natured. I mentioned to some the other day "that taking Coumadin makes you cold" is a lie. It would be nice to have the thermostat on a lower setting.

By the way, I should be proud - mine is 27mm!
 
I mentioned to some the other day "that taking Coumadin makes you cold" is a lie.

You can't say it's a lie, because some people do get cold. The reasons may not be Coumadin, but enough of them do to make it listed as a side effcet.
 
I remember feeling cold when I started on Warfarin, now I don't notice.

Anyway I missed all this discussion. I have a Regent, 29mm too, hehe

As for the INR discussion, I was told by the surgical folks to maintain 2.5 to 3.0. Then I saw the anti-coagulation clinic nurse and she said no way on God's earth will you maintain that. So I'm on 2.5 to 3.5

Ade
 
I like the advice given frequently here: much easier to replace blood cells than brain cells. I'm three years out of valve replacement surgery, and I've never seen anything recommended BUT the 2-3 range (well, my surgeon originally declared 2.5-3.5 ... but that's it.) I've banged myself, cut myself, bruised myself (even had a heavy metal desk fall on my head) and never had any bleeding issues. Your surgeon, I believe, becomes inconsequential the moment you leave the hospital after surgery. I'd get the advice from the INR folks and stick with them.
 
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