How to approach surgeon RE: using ON-X valve

[Ross]

I personally think many people on this forum takes the decision of a valve brand a little too seriously. Many problems with valve replacements are due to your body's response to the valve.

Technology must evolve and I get that, but you will find that many surgeons would rather work with something they have experience with. Leave it to ON-X to market their products, if they are as good as you say they are, the word will get around.

You are right dtread- the biggest issue is the type, not brand.

People should be more concerned with the surgeon's experience and the best option for you- whether it be catheter-based or surgical-based. If surgical, which surgery. Then- mechanical, porcine, bovine, homograft.

Another thing on this. Many people choose On-X in hopes that they won't have to be anticoagulated in the future. People have got to stop relying on the future and deal with TODAY. I can't help but wonder how many poor decisions have been made based on betting on the future.

 

[ALCapshaw2]

To my mind, On-X in not just another Mechanical Valve, but a Leap Forward with improved technology that provides some significant Risk Reduction compared with the older designs.

Jack Bokros, Ph.D., has been involved in the design of the Major Players in the Bi-Leaflet Mechanical Valve industry ever since his group discovered isotropic pyrolitic carbon.

The On-X Valve is his "latest and greatest" design in a 30 year career designing heart valves. It addresses some of the known 'problem areas' with the older designs such as Thromboembolism (Clot Formation), Fluid Dynamics (Turbulence), Hemolysis (damage to blood cells), and Pannus Tissue Growth impingement of the leaflets.

Pannus Tissue Growth is the leading reason for Mechanical Valve "explantation" (removal and replacement). The On-X Valve is the only valve with a Barrier to impede / prevent Pannus Tissue Growth from impinging the leaflets.

On-X can provide data comparing their valve performance to others in the industry (based on FDA Data submissions) which shows significant Risk Reduction with the On-X valve, especially in the more critical Mitral Valve position which is more prone to clot formation.

If you are going to get a Mechanical Valve,
why not get the one with the lowest Risk Factors?

If you are more concerned with a Long Record of Durability, the Master's Series St. Jude Mechanical Valve holds that record at 30 years and counting.

'AL Capshaw'

 

[Roger Frank]

To my mind, On-X in not just another Mechanical Valve, but a Leap Forward with improved technology that provides some significant Risk Reduction compared with the older designs.

Jack Bokros, Ph.D., has been involved in the design of the Major Players in the Bi-Leaflet Mechanical Valve industry ever since his group discovered isotropic pyrolitic carbon.

The On-X Valve is his "latest and greatest" design in a 30 year career designing heart valves. It addresses some of the known 'problem areas' with the older designs such as Thromboembolism (Clot Formation), Fluid Dynamics (Turbulence), Hemolysis (damage to blood cells), and Pannus Tissue Growth impingement of the leaflets.

Pannus Tissue Growth is the leading reason for Mechanical Valve "explantation" (removal and replacement). The On-X Valve is the only valve with a Barrier to impede / prevent Pannus Tissue Growth from impinging the leaflets.

On-X can provide data comparing their valve performance to others in the industry (based on FDA Data submissions) which shows significant Risk Reduction with the On-X valve, especially in the more critical Mitral Valve position which is more prone to clot formation.

If you are going to get a Mechanical Valve,
why not get the one with the lowest Risk Factors?

If you are more concerned with a Long Record of Durability, the Master's Series St. Jude Mechanical Valve holds that record at 30 years and counting.

'AL Capshaw'

Very well stated Al...your thoughts outline exactly why I requested On-X for my AVR surgery.

RF

 

[dtread]

UIHCCHI posted on 12/17/08:

"I personally think many people on this forum takes the decision of a valve brand a little too seriously. Many problems with valve replacements are due to your body's response to the valve.

Technology must evolve and I get that, but you will find that many surgeons would rather work with something they have experience with. Leave it to ON-X to market their products, if they are as good as you say they are, the word will get around.

You are right dtread- the biggest issue is the type, not brand.

People should be more concerned with the surgeon's experience and the best option for you- whether it be catheter-based or surgical-based. If surgical, which surgery. Then- mechanical, porcine, bovine, homograft."

Response:

I agree that first off the biggest decision of all is biological versus mechanical.

However, beyond that I also believe that valve brand is very important and is not to be ignored. There are definitely differences. This is very serious surgery, and the patient has to live with the results, good or bad, for the rest of their life (unless and including if they have to undergo a subsequent AVR, for whatever reason). That is why once I made the decision to go mechanical I then took it a step further by doing the research, analyzing the various options, and then chosing what I believe is the best mechanical heart valve on the market today.

The whole thing can be left to the cardiologist and surgeon. Just go in a say ?I?m broken Doc, please fix me?. Then show up for surgery. That is a choice.

For myself, I chose to be more proactive in my surgery because I am a fitness buff, and I wanted a valve that would not impede or hinder my fitness regimen, and that would provide the best long-term solution to my problem. That is the choice I made when I did not sit passively by and accept the valve brand that the surgeon wanted to use. I researched ALL the mechanical valves on the market, and, right or wrong, I made my choice.

So far, at 1.5 years post-op, I feel like I have won the lottery, as my recovery is near 100%. Actually, I think it is better than 100% because I don?t have the chest pain I had for fifteen years before the surgery.

My workouts are comparable to pre-op and the valve performs great at workout heart rates as high as the 170?s (I?m approaching senior citizen status so I don?t take it into the 180?s). I have no complaints.

 

[Woodbutcher]

I dont really know a great deal about the different valves, however during the short couple of weeks I had to research them as a total layman all in roads seemed to lead me to the On-X ? As a company they were responsive and organised and liaised with my Hospital ultimately sending a rep down with all the requisit on the day of my op. I've nothing but praise for them.
I think any surgeon worth his salt wouldn't totally disregard your request and alot of the time as was the case for Derriford (Hosp) they have to use the St Jude, CarboMedic and ATS valves because they're "on the shelf" and already paid for. My surgeon was kind enough to organise the On-X for me but at pains to point out that he didn't think it was any better than any other he'd have used ? Please pm me if you'd like further details and good luck .

 

[Brad (AKA "Croc")]

Cardiologist Should Work With Surgeon on Valve Choice

Cardiologist Should Work With Surgeon on Valve Choice

All,
This is my first post. I had AVR on 11/13/2008; received the On-X 29mm Aortic Valve. I'm 50 years old, and an Engineer. I did research on all the common mechanical aortic valves. The On-X valve stood out in quite a few areas. I requested information from all the companies; some were more helpful than others. My Cardiologist had already done some research on the On-X valve, and he initially recommended it to me. Once the Surgeon was chosen, my Cardiologist met with him, and they came to a consensus before I met with the Surgeon to use the On-X valve; assuming there was nothing structural that would cause a problem. I was the second patient he had implanted the On-X valve in. He indicated that the vast majority of the AVR's he performs he uses the St. Jude valve, but with recent information he had received he didn't disagree with the choice of the On-X valve. From the research I've done concerning the implantation of the valve, there isn't a lot of difference for the Surgeon.

I'm 5 weeks post op, and I already feel better than I have in several years. I've returned to work, but my Cardiologist has requested I wait until 6 weeks to actually drive. That, and the 10 pound lifting limitation are 2 of the more irritating issues I'm getting used to; sleeping after the Surgery was the biggest issue I had to work through.

Some may wonder why I included the (AKA "Croc") in my signature. A friend nicknamed me Croc because he can hear my valve from 5+ feet away. "Croc" is the reptile from the Peter Pan fairy tale (the Croc took Captain Hook's hand; he was fed an Alarm clock so they could hear him coming).

 

[Fran]

Hi, Tree! My surgeon was the one who told me about Onx valve, but also let me be involved in the process. I researched on line, talked to those who had rec'd St Jude's (all doing beautifully) and I ended up just feeling very comfortable with my surgeon's input being the right decision. So much of this ends up being 'gut" instinct-type responses. All I know is when I walked out of his office on Good Friday '07, I was literally shaking with the relief of having this man in charge. I'd been at another practice for a year and a half and never ONCE met a heart surgeon, dealt with the nurse prac, and she was great, but no one ever stepped into the exam room to introduce himself. Dr A sat with me and my family for over an hour, discussing this, showing my daughter what was what on the pics.

You can't go with personality so much but commitment to the patients via attitude and willingness to put your fears at rest have to be part of the process.

I didn't have to be afraid at all. That is so much a part of the healing process, having no fear.

My best to you. It's a very individual thing, but wow, you're going to feel like a million bucks about two months later! No arrythmias, no weakness, nice regular strong heartbeats. WOW! It's so worth it.