Hoping 3rd time is the charm

[Mrviking9!]

Hello peeps new guy here getting ready for my 3rd AVR with the On-X valve. Here is some background on me and I have a question later about my heart remodeling after surgery I’ll try to keep this short as possible but no guarantees (lol) In 22 I went to my primary he said my murmur sounded more pronounced and I should check in with cardiologist which I did he gave me a listen said I valve sounded ok and I could get an echo in 6 months if I’d like I said sure well 6 months turned to 9 cause they never notified to schedule like they always have so me being the ***** that I am thought no news is good news well now I have symptoms so I call and get the echo turns out the ****** Abbott trifecta GT has turned into a dried pice of cabbage I had from previous surgery’s acquired LV hypotrophy but now my left atrium is the size of a hand grenade and the pressure gradient across the vale is high enough to send a chimp in a small rocket into the stratosphere my ejection fraction is high normal believe or not but my symptoms have gotten greater recently I’m happy my surgery is a few weeks away in fact I would run to that table if I could the day of surgery to get this over with do you think it’s possible for my heart to remodel enough to give some quality of life back I’m worried cause this surgery should have happened months ago please and thank you

 

[dick0236]

Welcome Mrviking9. I hope all goes well with the new Onyx valve. We have quite a few Onyx owners who visit this site frequently. Ask any questions you have and you will get some good input.

 

[Chuck C]

Hi and welcome to the forum!

do you think it’s possible for my heart to remodel enough to give some quality of life back

The short answer is yes.
You will almost certainly feel much better after your SVD valve is replaced. Your heart will remodel. It's not possible to say whether it will do so completely, but it will remodel once your LV does not have to take on the immense task of getting blood through that little opening and the pressure is returned to normal. There are other factors, such as how much your LV walls have thickened, but the good news that you shared is that you have preserved ejection fraction. The cases that are very concerning are when the person is well down the road to heart failure with a low EF. So, that is good news that this does not describe your situation.

Best of luck with your procedure. Glad that you are getting it now and not waiting any longer. Please keep us posted on your recovery and we will see you on the other side

 

[Mrviking9!]

Welcome Mrviking9. I hope all goes well with the new Onyx valve. We have quite a few Onyx owners who visit this site frequently. Ask any questions you have and you will get some good input.

Thank you, good to know I appreciate it

Hi and welcome to the forum!


The short answer is yes.
You will almost certainly feel much better after your SVD valve is replaced. Your heart will remodel. It's not possible to say whether it will do so completely, but it will remodel once your LV does not have to take on the immense task of getting blood through that little opening and the pressure is returned to normal. There are other factors, such as how much your LV walls have thickened, but the good news that you shared is that you have preserved ejection fraction. The cases that are very concerning are when the person is well down the road to heart failure with a low EF. So, that is good news that this does not describe your situation.

Best of luck with your procedure. Glad that you are getting it now and not waiting any longer. Please keep us posted on your recovery and we will see you on the other side

thanks for your input and kind words I will keep folks updated on my recovery for sure

 

[pellicle]

Hi and welcome

Abbott trifecta GT has turned into a dried pice of cabbage I had from previous surgery’s

Having had my third in 2011 (@48) I'm sort of curious about the previous histories (if you don't mind sharing that briefly. My history is in my about

https://www.valvereplacement.org/members/pellicle.12469/#about
Just make sure that you don't disregard your INR management and don't be pretending that the On-X is a magic valve to spare you from warfarin, because basically it isn't and you don't want more risky events.

I can't comment about remodelling because that really depends on many factors.

Anyway, welcome aboard

 

[Mrviking9!]

Hi and welcome

Having had my third in 2011 (@48) I'm sort of curious about the previous histories (if you don't mind sharing that briefly. My history is in my about

https://www.valvereplacement.org/members/pellicle.12469/#about
Just make sure that you don't disregard your INR management and don't be pretending that the On-X is a magic valve to spare you from warfarin, because basically it isn't and you don't want more risky events.

I can't comment about remodelling because that really depends on many factors.

Anyway, welcome aboard

Well my troubles started at 42 when it was discovered I had aortic valve regurgitation from bicuspid valve. They keep me going and monitored me for 5 yrs had first AVR in 08 surgeon I think should have suggested mechanical valve cause of my age but he gave me a choice with pros and cons for both I choose tissue I regret that move I truly do. Anyway that valve lasted 9 yrs went bad in 2017 again I had a choice and was leaning to go mechanical surgeon this time advocated for a new tissue valve, stented with anti calcification properties low gradient numbers and great early reviews he said this valve would get me to my 70s then TAVR this valve was made by Abbott who just bought out St Jude medical it’s called the trifecta GT. Well this valve has started failing early FDA issued warning in Feb this yr I got 6 yrs so here we are I’m ending up where I should have started. I am a candidate for TAVR but at 62 not realistic I think. I want to be done with this once and for all. I am under no illusion that ONYX is the magical cure all and warfrain scares the crap out of me but I will be diligent in managing my INR. So that’s my sad story sorry if it was long winded

 

[pellicle]

Hi

firstly I just want to say I'm so sorry you had a sugeon who didn't guide you. Next I want to thank you for your candour as I just wish more sub 40 year olds would actually read this and make the "reality based" decision (not the fanciful one with hard outcomes)

08 surgeon I think should have suggested mechanical valve cause of my age but he gave me a choice with pros and cons for both I choose tissue I regret that move I truly do

as to this point

I am under no illusion that ONYX is the magical cure all and warfrain scares the crap out of me but I will be diligent in managing my INR.

I'm glad to hear that (and then wonder why you'd pick On-X (its not onyx btw) when there are reliable reasons to not choose it. Lets just start with all their claims and then the more easily measured ones do not stack up against the claimed, so why would you then expect any of them too?

With respect to managing INR you really do not need to fear warfarin, you just need to understand it. Reach out if you want to discuss this more.

Either way you are on the right path and have your mind set in the best manner it would seem.

Best Wishes

 

[Timmay]

I’m an On-X aortic valve guy. Installed in 2022. I maintain a “normal” INR range and not the lower one that Artivion says you can use (makers of On-X). For me, personally, I would never run that 1.5-2.0 range.

The On-X and St. Jude’s mechanical valves - so far - appear to provide the same mortality. That said, the On-X is a bigger prosthesis. That means you’ll technically have a smaller valve for the same size when comparing to St. Jude’s. My surgeon had to do an aortic root expansion to fit a somewhat properly sized On-X valve. And sometime I question the size that they used … thinking that I could benefit from a larger one. I only have a 23mm On-X. And mods were needed to fit THAT one. A 25mm valve would have been nice … could have probably gone that path with a St. Jude’s valve.

My point? Talk to your surgeon about prosthesis to patient match. You DEFINITELY don’t want to end up with a valve that is too small. You think that this wouldn’t happen but it does most definitely still happen … unfortunately.

Find some pics of the on-x compared to the St. Jude. It’s a huge difference.

The On-X is supposed to have better panus protection though. I think the jury might still be out on that one though.

If I could do it all over again, I’d probably go with a St. Jude and have a much much longer discussion with my surgeon about valve size.

 

[pellicle]

You DEFINITELY don’t want to end up with a valve that is too small.

To be clear, I think Tim is talking about the diameter of the orifice here, not the bulk of the valve (could be wrong)

 

[Timmay]

To be clear, I think Tim is talking about the diameter of the orifice here, not the bulk of the valve (could be wrong)

That is correct. Not the overall size, but the actual open area … the orifice as you say

 

[Atreus]

Hello peeps new guy here getting ready for my 3rd AVR with the On-X valve. Here is some background on me and I have a question later about my heart remodeling after surgery I’ll try to keep this short as possible but no guarantees (lol) In 22 I went to my primary he said my murmur sounded more pronounced and I should check in with cardiologist which I did he gave me a listen said I valve sounded ok and I could get an echo in 6 months if I’d like I said sure well 6 months turned to 9 cause they never notified to schedule like they always have so me being the ***** that I am thought no news is good news well now I have symptoms so I call and get the echo turns out the ****** Abbott trifecta GT has turned into a dried pice of cabbage I had from previous surgery’s acquired LV hypotrophy but now my left atrium is the size of a hand grenade and the pressure gradient across the vale is high enough to send a chimp in a small rocket into the stratosphere my ejection fraction is high normal believe or not but my symptoms have gotten greater recently I’m happy my surgery is a few weeks away in fact I would run to that table if I could the day of surgery to get this over with do you think it’s possible for my heart to remodel enough to give some quality of life back I’m worried cause this surgery should have happened months ago please and thank you

Hi! Welcome to the forum!
Your heart will remodel after some time, Don't be afraid, as long as your ejection fraction is close to normal it means your heart muscle is still in good condition. Before my first surgery, my heart was close to a Christmas globe, but after 6 months my doctor said that it went back to a close normal range .
After your surgery and recovery, you will feel a lot better and you will have more energy to do anything you please!
I wish you the best!

 

[Mrviking9!]

Hi! Welcome to the forum!
Your heart will remodel after some time, Don't be afraid, as long as your ejection fraction is close to normal it means your heart muscle is still in good condition. Before my first surgery, my heart was close to a Christmas globe, but after 6 months my doctor said that it went back to a close normal range .
After your surgery and recovery, you will feel a lot better and you will have more energy to do anything you please!
I wish you the best!

Thank you for your input and encouragement appreciate it

 

[Mrviking9!]

Hello friends, Well I made it thru 2nd redo (3rd AVR surgery). It was a complicated and long surgery. But my surgeon did an amazing job no complications. It took him 4 hrs just to access the heart due to all the scar tissue and adhesions. And amazingly there was no bleeding issues. Surgery took place Wednesday afternoon 09/20. I only spent 12 hrs in ICU then to the cardiac step-down unit and I’m progressing nicely. They are most likely cutting me loose on Sunday. My surgeon was able to fit me with a brand spanking new 27mm On-X valve. Surgery was at URMC Strong Hospital in Rochester, NY. So relieved it is over. Let the healing begin. Thanks, Jimmy

 

[Beach77]

Glad your surgery is over and you're on the mend! Your surgery sounded very challenging! I also have a On-X 21mm valve @ 64 turned 65 when I left the hospital. It'll be 3 years in December. Praying for your recovery!

 

[Mrviking9!]

Thank you for your prayers very much appreciated

 

[pellicle]

and I’m progressing nicely

Great to see

Here's wishing you an event free recovery

 

[Chuck C]

Welcome, once again, to the other side!

Thanks for the update. Best of luck with your recovery.

 

[Innovativebrain]

Pleased to hear that you had a great surgical team and you came through well!

 

[DByrner]

Hello friends, Well I made it thru 2nd redo (3rd AVR surgery). It was a complicated and long surgery. But my surgeon did an amazing job no complications. It took him 4 hrs just to access the heart due to all the scar tissue and adhesions. And amazingly there was no bleeding issues. Surgery took place Wednesday afternoon 09/20. I only spent 12 hrs in ICU then to the cardiac step-down unit and I’m progressing nicely. They are most likely cutting me loose on Sunday. My surgeon was able to fit me with a brand spanking new 27mm On-X valve. Surgery was at URMC Strong Hospital in Rochester, NY. So relieved it is over. Let the healing begin. Thanks, Jimmy

Good to hear. I’m in for my 3rd OHS on Wednesday. My mitral this time so it’s nice to see how well it can go. Speedy recovery to you.

 

[Mrviking9!]

Good to hear. I’m in for my 3rd OHS on Wednesday. My mitral this time so it’s nice to see how well it can go. Speedy recovery to you.