Do You Have An On-X Valve?

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Ross

Well-known member
Joined
Dec 15, 2001
Messages
25,981
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Sharad is looking for members who have had the On-X valve implanted. Would you please speak up if you've had one implanted?

Thank you!
 
i have

i have

.
i have an on-x valve in the mitral position and i am totally satisfied and living a normal carefree life
 
Here is a copy of a post from member "dtread" in Oct 2008 regarding his choice of On-X.

From www.ValveReplacement.com - Valve Selection Forum -
"Message from the Founder" Thread - Reply #60 by "dtrend"

Mr. Magoo thinks that valve choice should be left to the surgeon. Pick a good surgeon, and then let the surgeon decide the valve. The implication is that the “Valve Selection” forum should be changed to “Surgeon Selection”. Pick a good surgeon, who has completed at least two dozen implants of whatever valve he/she decides to use, and you’ll do okay.

I do not agree with this very conservative and quite passive position. If I did I would not have an On-X valve; I would have a St Jude.

When I became aware that I would be having a valve replacement, I only had a few weeks prior to the surgery to prepare. I was told I would be getting a St Jude valve. I went onto the Internet and went to each and every valve manufacturer’s website to see what they had; to compare with St Jude to see if they had anything that would make them a better choice than St Jude. I specifically performed my research being aware that the websites would be using marketing strategies to promote their product, and to try to “read between the lines” so to speak.

I ruled out the Medtronic Hall Easy-Fit Valve because I do not like the tilting disc design. I ruled out the ATS Open Pivot and Carbomedics bileaflet valves simply because they did not seem significantly different than the St Jude. However, when I got to the On-X website, I thought that it looked pretty interesting.

I have a Master’s degree in Marketing, and in my work in telecommunications I have dealt with many sales people and marketing strategies. I continued researching over a period of several days, specifically gathering information on St Jude and On-X. It was easy to see that St Jude is like the General Motors of heart valves, and that On-X was much smaller. However, when I looked at the data, and the other advantages of the On-X, it seemed to have many advantages; e.g.:

Lowest rate of thromboembolism
Lowest mortality rate
Highly polished hinge pivot area for less chance for clots to form
Leaflet guards to prevent pannus ingrowth

I contacted On-X to get additional information on the hemodynamics of their valve. I was particularly interested in this aspect because I have always been a fitness buff, and I wanted the best valve available so that I would have the least impairment to my fitness regimen. On-X provided me with additional information that confirmed that the On-X had hemodynamics that were at least as good, if not better than the St Jude, and with a lower mortality rate. I learned that the same person (Dr. Jack Bokros) worked on the design of the St Jude, Carbomedics, and ATS valves, and also designed the On-X. I realized that the On-X represents the latest technology in heart valves. I was sold on the On-X.

At my appointment with the surgeon I indicated to him that I wanted the On-X. At first he totally dismissed the notion, but I persisted and he finally agreed to take a look at it. He asked if I wanted to be the first, and I indicated that I was. I was willing to accept what I considered to be a pretty low risk. Right or wrong, I was going to have to live with this decision, but I wanted the best valve available. In the following days On-X contacted the surgeon on my behalf (and with my approval) and got everything set up, and sent a representative in who was present during the surgery to assist the surgeon. The day after the surgery the surgeon indicated to me that the surgery “went perfect”. I did not specifically ask him whether he had any difficulty with the implant, and he did not indicate anything unusual.

I considered being the first to receive the On-X to be low risk for a couple of reasons. For one, all the valves are pretty similar in design and implantation of one valve is not all that different than implantation of another. For another, surgeons are trained to adapt and think on their feet in stressful situations, and I do not think that implanting a new valve (to the surgeon) would add much risk to the equation. Mr. Magoo indicates a “cutoff of at least 2 dozen cases” before he would want a surgeon to implant a particular valve. This indicates to me that Mr. Magoo must have either a financial or some other interest in either ATS, Carbomedics, or St Jude. If you can believe Mr. Magoo from the “USA”, it is indicated that “in a past life I spent a couple of decades in the heart valve business”. Well, perhaps Mr. Magoo owns stock in ATS, Carbomedics, or St Jude. Or perhaps Mr. Magoo has some ties to one of these companies, is friends with present employees, or has some other relationship that ties Mr. Magoo to one of these companies. The reason I say this is that if Mr. Magoo can get future valve recipients to listen to his/her message of “let the surgeon pick the valve” and “cutoff of at least 2 dozen cases” Mr. Magoo can at least slow up, or block On-X sales. And letting the surgeon pick the valve allows sales of ATS, Carbomedics, and St Jude to continue as they have in the past. For all we know Mr. Magoo is presently in sales or marketing for ATS, Carbomedics, or St Jude, and this is simply part of his/her job. Or perhaps Mr. Magoo got snubbed in some way when On-X was formed, and has some grudge against On-X.

I believe that the way it works in most cases is that the hospital or medical center has contracts with specific medical suppliers for goods. I do not believe that most medical centers have a stock of valves on hand from Medtronics, ATS, Carbomedics, On-X, and St Jude, and the surgeon makes a decision that “I think I’ll use an ATS on Mr. Smith, and a Carbomedics on Mrs. Jones, and an On-X on Mr. Taylor”, etc. The valve choice has already been decided long ago through the contract that the medical center or hospital has, and the surgeon pretty much uses the same valve on whoever comes through for surgery. I am sure that the Chief of Cardiology had a major influence on the decision on what valve company got the contract, or it may have been decided by whoever was the low bidder, or there may have been other factors.

Subsequent to my surgery over a year ago I believe that my decision to go with the On-X valve was a wise choice. At one-year post op I was virtually 100% recovered from the surgery. My workouts in the gym (twice a week) consist of a half an hour on the weight machines (chins, dips, curls, tricep press, bench press, overhead press, butterfly, lat pull down, leg extension, abdominals, leg curl, etc.), then 15 minutes on the Concept 2 rowing machine, then 15 minutes jogging on the treadmill, and ending with 30 minutes on the elliptical machine (1.5 hours total workout). On top of that I do an 18-mile loop on my bicyle twice a week, which takes just over an hour each time. I wear a heart rate monitor, and my heart rate during workouts is usually between 140 to 165 bpm. The highest I’ve taken it to is 176 bpm for a short period on an uphill. The On-X valve has performed flawlessly in all cases. My times for the 18-mile loop on the bicyle are consistently equal to the best times I had pre-op.

Regarding the anticoagulation issue, with me it became practically a non-issue once I got on home monitoring. The side effects of the Warfarin are practically nil, and the monitoring is definitely no big deal. I do take great comfort in knowing that the On-X valve has the lowest rate of thromboembolism, and in the knowledge that there are a whole bunch of folks in Africa and Australia that have been (and are still) running around with NO anticoagulation at all. I believe that provides me with at least an extra margin of safety.

The “Articles” tab on the VR.com home page and the PTINR.com tab at the top of the VR.com forum page both take you to the Heart Valve tab of the PTINR.com website. This puts “Carbomedics” right in your face. Does this mean that Carbomedics is subsidising VR.com? This has been there as long as I can remember, but I’ve only been a member a little over a year. I don’t know that anyone raised any fuss over that, and Mr. Magoo did not mention it.

I am not an employee of any valve or medical company, do not work in the medical field, did not receive any coaching and am not receiving any compensation whatsoever for the above commentary, and do not own any stock or other interest in any heart valve company or medical concern. The above comments are not to be construed as any kind of medical advice and simply reflect my own opinions and experiences. Anybody that wants proof that I had valve replacement is free to come to the Washington, DC area and I will be happy to show them my scar and the hospital bills as proof. I also have some pictures from when I was in the hospital.

I have one question for Mr. Magoo, which I don’t think that he/she will be able to answer:

Is Lisa in Katy going to get her Massage from the Founder?
__________________
Dan
AVR 06/05/07, On-X 21mm Aortic Valve, Dr. Ammar S. Bafi, Washington Hospital Center, Wash, DC. And Medtronic Model ADDR01 Pacemaker.
Pre-Op: http://www.youtube.com/watch?v=-vlrn7mVqrw
Surgery: http://www.youtube.com/watch?v=7RQSHbqGsTI
Post-Op (hospital):http://www.youtube.com/watch?v=tHw9b4BBV9Y
Post-Op (out of hospital): http://www.youtube.com/watch?v=HJ8mQ...eature=related
Recovered: http://www.youtube.com/watch?v=49iQut6K0qE
 
Here is a copy of a post from Randy & Robin documenting the First On-X implant at Cleveland Clinic in Feb. 2006. CC added On-X to their standard mechanical valve offerings earlier this year (or so I am told).

=========

On-X at Cleveland Clinic

---------------------------------------------------------------

My wife and I head for Cleveland Clinic on Sunday. I have a full day of tests Monday. Tuesday I meet with the preop team and Dr. Pettersson, my illustrious surgeon.

It has also become official that I will be able to get my On-X after all. A vendor has been contacted to supply the valve and a nurse from MCRI, the manufacturer of the On-X, will be in attendance at my surgery. I will be the first patient at CC to have the On-X implanted.

It also sounds like I might have become the impetus for Cleveland Clinic to begin utilizing the On-X in their valve surgeries. Dr. Pettersson thanked me for sparking several internal discussions amongst the surgeons there concerning the potential benefits the On-X might provide their patients.

Both Dr. Lytle and Dr. Pettersson expressed their interest in the valve and admitted it had several features that could well be advancements over other mechanical valves. Dr. Petterssonn said it was hard not be impressed with the technology.

I am quite certain they would in no way be interested in participating in the reduced anticoagulation trial recently approved by the FDA for the On-X. Dr. Pettersson said it may be possible for this valve to perform well on plavix or just aspirin but to find out you have to take risks with patient's lives and they are not willing to accept that.

I did mention to Dr. Pettersson that I have had several major nosebleeds in the past few years, one that required a trip to the ER. He said that was a yellow flag for anticoagulation and scheduled me to see an ENT specialist during my preop testing. He feels that could be an issue to consider at our meeting on Tuesday. I am hoping they will find nothing to contraindicate a mechanical valve. A third surgery would not be a pleasant prospect.

Randy
__________________
Diagnosed with severe aortic regurgitation January 2005
Aortic valve repair at Mayo on October 13, 2005
Two weeks later, repair failed.
Aortic valve replacement with On-x 25mm on February 16, 2006 at Cleveland Clinic by Dr. Gosta Pettersson.

===============

I recall reading other posts from Randy discussing his selection of the On-X valve. See his "member profile" for links to his (309) posts.
 
On-X here, aortic poistion. 15 months removed from surgery. No meds with the exception of coumadin. No restrictions either but my cardio basically said to use common sense. Full contact sports (football, rugby, hockey, etc...) is probably a no-no with he concern of internal bleeding. Now that Im fully recovered I've gone back to my everyday life except now I can run and not have chest pains or SOB. The only thing I've really changed is watching myself with alcohol. I still knock back a few on the weekends, just a few less than before :)
 
I have a On-x in the mitral position. Yesterday was 8 weeks... I have to take coumadin and a blood pressure medicine right now. I am hoping the results come back to no coumadin in the future. I have no lifelong limitations except for the full contact sports as scott stated above....
 
I have one...I love it!

I have one...I love it!

Sharad

I am now celebrating my second anniversary of having my ascending aortic aneurysm repaired and having an On-X valve implanted. I am a 62 year old active (bicycling) male. If your photograph is accurate, you apppear to be quite young. One of the significant factors affecting my decision to go with the On-X was that I did not really want to undergo another open heart procedure when I was in my 70s or 80s. If you are indeed a young guy, the On-X may really be the best option for you, as it will most probably last you for the rest of your life.

I am on warfarin and have been for two year, and have had no major problems with it, other than the occasional out of range INR mishap. On one occasion for some reason my INR dropped to 1.5. With any valve other than the On-X I might have been in dangerous territory for a clot to form. But with the On-X I am convinced that the risk of thromboembolism is quite low.
I currently am maintaining an INR in the 2.5 - 3.5 range. I am taking 7.5mg of warfarin per day. But everyone's warfarin dosage will be different.

And I am quite hopeful that the Proact study now underway for the valve will eventually allow those of us who have the On-X implanted to use Plavix and aspirin for anticoagulation rather than warfarin.

For technical discussion on the forum read everything by ALCapshaw2. He has a great deal of information on the On-X.

Best of luck with whatever vavle you choose.
 
I have an On-X valve in the aortic position. I am 20 months post surgery. Currently I am taking Coumadin. I honestly don't think it is burden. I home test so I can keep my own eye on my INR.
 
First On-X at Cleveland Clinic

First On-X at Cleveland Clinic

As Al stated in his post, I was the first to have the On-X at Cleveland Clinic in February of 2006. Just thought I would chime in and say that I am extremely pleased with my decision.

Before my surgery the walls of my heart had thickened considerably due to the faulty valve. I just had a routine echocardiogram a month ago and my cardiogist was happy to inform me that my heart is back to normal size and looks very healthy. He was quite impressed with the valve's functioning.

I wouldn't hesitate to recommend the On-X to anyone.

Randy
 
As Al stated in his post, I was the first to have the On-X at Cleveland Clinic in February of 2006. Just thought I would chime in and say that I am extremely pleased with my decision.

Before my surgery the walls of my heart had thickened considerably due to the faulty valve. I just had a routine echocardiogram a month ago and my cardiogist was happy to inform me that my heart is back to normal size and looks very healthy. He was quite impressed with the valve's functioning.

I wouldn't hesitate to recommend the On-X to anyone.

Randy
Hey Randy! Good to see you. I'm glad you are doing well.
 
8 gms

8 gms

Hi!

Do you need Anti-coagulation? what extent?
What are the precautions that you need to follow?

i currently take 8 gms of warfarin per day. otherwise i take no precautions and have and accept no limitations.
 
I have had my On-X in the Aortic position for 4 months now. Taking 10/11mg warfarin/day and continuing with Lipitor 20mg, Ramipril 10mg and Asprin 81mg as before surgery. Valve is very quiet and even my wife's bionic ears don't hear it much:). Warfarin is a non issue - I home test and self dose and don't do any stupid things, but still cook with big knives:D. Have bumped and scraped and cut myself during normal life with no ugly consequences;). Energy levels are up SOB down and I feel way better than before the surgery even though I was pretty asymptomatic - I had just gotten used to the slowly deteriorating situation.
Cameron
 
Sharad, I had On-X aortic valve implanted two years ago and it works great. I put it to the test all the time in the gym and on my bike, and it works fine. I've had my heart rate up in the 170's many times while exercising with no problems. The best part is that I don't have all the chest pain I had before surgery.

Regarding Coumadin, what you ought to do is follow the American College of Cardiology/American Heart Association (ACC/AHA) Guidelines for the Management of Patients with Valvular Heart Disease. They update the Guidelines periodically. The latest Guidelines were published in 2006, and recommend an International Normalized Ratio (INR) range of 2.5 - 3.5 as being reasonable during the first three months following Aortic Valve Replacement with a bileaflet valve. After the first three months it is reasonable that the INR can be lowered to 2.0 - 3.0. This is for patients with no risk factors, i.e.:

- Atrial fibrillation
- Previous thromboembolism
- Left Ventricle (LV) dysfunction
- Hypercoaguable condition

The Guidelines do not distinguish between a particular bileaflet valve brand and another; i.e., the recommendations are the same for all the bileaflet valves.

The only difference with the On-X is that there is an ongoing Clinical Trial regarding Coumadin use with the On-X. The Clinical Trial will not be completed until 2015. Details on the Clinical Trial can be found at: http://www.clinicaltrials.gov/ct2/show/NCT00291525?term=on-x&rank=1

Until the Clinical Trial is successfully completed you should follow the latest ACC/AHA Guidelines.

I am not a medical practitioner and the above is not to be considered medical advice. Check with your Doctor regarding any medical condition.
 
Sharad, I have an On-X valve - Aorta. I'm 5 months post surgery and am doing great. I had an echo last week and was very pleased to learn that my heart function and size had returned to normal. I am part of the PROACT study and in the low-dose warfarin control group. My INR target range is 1.5-2.0 and it usually reads around 1.9. I take 27.5 mg of warfarin a week, and home monitor. The valve is quiet and I rarely even think about it anymore.
 
Hi Sharad,

I had an On-X implanted in December 09. 5 months ago and all seems to be well for me. The ticking still annoys me but otherwise my life is pretty much back to normal. Except I think I have a heightened awareness to my health and probably am looking after myself more with regards diet and exercise. I'm feeling pretty fit and organising a 1000 mile cycle ride too. The only drug I take is Coumadin (Warfarin) 3mg / 4mg a day with an INR of around 2.8. Much to the surprise of many members on here (I should think) I only have a blood test every 10 weeks now, which maybe isn't really enough but that's the way my local Health centre plays it. The first three months was pretty much every week with my INR always around 2.8.
 
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