I've decided on the OnX...

[ctyguy]

Im 18 months post-op, On-X in the Aortic position. 1 yr checkup was a rubber stamp, Im now only on Coumadin. I've ditched the Beta-blocker and Aspirin per my Cardiologists instructions. My INR has been as low as 1.7 and as high as 3.7 (just recently due to a few too many beverages )

The two things I've noticed post-op are unrelated to the valve but I attribute to the surgery. My hair is thinner (thanks Coumadin) and my stomach is alot more sensitive to fun foods (spicey).

 

[Hot Rod Harry]

I've decided on the OnX...

...If a repair can not be done. My reasons are, that through research, are that it is the latest, with improvements over the St judes. Dr Pettersson and I discussed this valve, and he is convinced that it provides the best of todays technology.

I thought I might qualify for the plavix-asprin in the future, however, speaking with the research team, they have stated that I am a candidate for the low dose cumadin study, but not the plavix-asprin, because my replacement would be in the mitral valve position, which is more apt to clotting, but I do qualify for the low dose trial study.

I opted out of the study. After talking to the study team, the only advantage to me would be that they would pay for the INR home testing equipment, and I would be on a lower dose of cumadin. From my standpoint, I'm 3 1/2 hrs from Cleveland, and to take the time off from work to go there for the many test that they would like to perform, would be a negative for me. If I lived closer, it would not be as big a deal. If the study works out, then I would then be able to take advantage of the lower dose of cumadin anyway.

So, if a repair is not an option, I am going with the OnX, because it's proven, it's the latest in technology, it has the potential for lower doses of cumadin in the future. Go under the knife in 4 days.

 

[Tbone]

Well I hope it all work out well for you. Do you have a surgery date yet?

 

[Freddie]

Tbone, he's going under the knife in 4 days.....silly Tbone

Best of luck to you Hot Rod.

 

[Ross]

You wouldn't necessarily have to go back to Cleveland for testing. I'm sure you've got plenty of clinics around you, but home testing is a whole lot better!

My honest opinion of Plavix is that it's more dangerous then Coumadin. Just had to throw that in.

 

[Eva]

Good luck and best wishes. As Ross said, discuss with them 'home testing'!

 

[westie]

great choice

great choice

.
i think you have made an excellent choice of valve. hopefully your surgery will be painless like mine and that you quickly bounce back better than before

 

[Hot Rod Harry]

You wouldn't necessarily have to go back to Cleveland for testing. I'm sure you've got plenty of clinics around you, but home testing is a whole lot better!

My honest opinion of Plavix is that it's more dangerous then Coumadin. Just had to throw that in.

I do have plenty of clinics around me, but it's not the testing of the INR I was worried about. They wanted me to come back for 5 years of a multitude of testing. I have the information packet they gave me. When I'm felling better, I'll list the many test that they want to do. Point being, taking time off work to drive or fly to Cleveland would not have been an advantage. If I lived near Cleveland, it would have been an advantage.

However, it's still going to be an advantage to have the OnX valve in the mitral position.

 

[ALCapshaw2]

However, it's still going to be an advantage to have the OnX valve in the mitral position.

AMEN !

It's good to see someone who "Get's It"
that the Real Advantage of an On-X valve has nothing to do with reduced anticoagulation and Everything to do with a Lower Risk of Clot Formation, especially in the Mitral Position !

 

[dl_mooney]

Thats the same valve i have picked out, wishing the the best in your surgery, please keep us posted.With the On X you have to maintain a INR of 2.0-2.5.I sure hope my Surgeon goes along with what I want.

 

[bahlvarun]

my surgeon is a sjm fan and says he does not believe in the studies as they are motivated by companies is what he says, so i'll have to go with SJM, else its gonna cost me almost 5times more.

currently my sugery will cost only $4000/- else it may $20000/-

So good luck to you...

 

[Hot Rod Harry]

Thats the same valve i have picked out, wishing the the best in your surgery, please keep us posted.With the On X you have to maintain a INR of 2.0-2.5.I sure hope my Surgeon goes along with what I want.

The INR that you quoted, is only proven safe after the trial study goes through it's motion. Otherwise, it's going to be the same INR as anyone else, but in my opinion, has less chance of clotting, especially if it is in the mitral valve position, as Al stated above.

 

[uchong]

On-x

On-x

The INR that you quoted, is only proven safe after the trial study goes through it's motion. Otherwise, it's going to be the same INR as anyone else, but in my opinion, has less chance of clotting, especially if it is in the mitral valve position, as Al stated above.

I have an ON-X and not on the study and my INR is to be 2.0-2.5

 

[Ross]

my surgeon is a sjm fan and says he does not believe in the studies as they are motivated by companies is what he says, so i'll have to go with SJM, else its gonna cost me almost 5times more.

currently my sugery will cost only $4000/- else it may $20000/-

So good luck to you...

Pffft, be a man and come to the U.S., it'll only cost you around $150,000.

 

[Hot Rod Harry]

I guess I should update this thread, and say that the surgeon was able to perform a mitral valve repair. He said the tissue looked very healthy, and the reasons the first MVR 3 years ago failed, is because the sutures came loose, and the ring was too large. They did the repair, and now I have zero leakage. I hope I dont ever need another surgery, but if I do, I'll access things at that point.

 

[Roger Frank]

Along the same lines...

http://www.sciencedaily.com/releases/2009/06/090629165554.htm

Four Out Of 106 Heart Replacement Valves From Pig Hearts Failed, Study Finds

ScienceDaily (June 30, 2009) ? Pig heart valves used to replace defective aortic valves in human patients failed much earlier and more often than expected, says a report from cardiac surgeons at Washington University School of Medicine in St. Louis. This is the first report to demonstrate this potential problem, the researchers say.

 

[Perry]

...the only advantage to me would be that they would pay for the INR home testing equipment, and I would be on a lower dose of cumadin.....

What is the target INR for the OnX testing - anyone?

Perry

 

[ALCapshaw2]

For patients who are NOT participating in the Low / NO Anticoagulation Studies, the recommended INR Range for On-X Valve Recipients is the Same as for other Mechanical Valves, typically 2.0 to 3.0 for the Aortic Position with NO additional Risk Factors and 2.5 to 3.5 if there are additional Risk Factors such as Stroke, TIA, DVT, etc.

For the Mitral Valve Position, the typical recommended INR Range with NO additional Risk Factors is 2.5 to 3.5. With additional Risk Factors, this may be increased to 3.0 to 4.0.

Some Doctors use slight variations on these recommendations and some even specify more Narrow Ranges which is Difficult (if not impossible) to maintain due to several factors including individual variation, test strip and test instrument variation / tolerances, etc.

 

[bahlvarun]

Pffft, be a man and come to the U.S., it'll only cost you around $150,000.


Thanks for the offer but no thanks...!!

Infact I was smart enough to understand this and leave US before I thought I would be stuck up there...

 

[SHEEPDOG]

on-x inr

on-x inr

I have On-x in the Aortic valve and am NOT in the study. My doc said 2.0-2.5. I have hit 1.7 as a low and 3.1 as a high in the past year and had no probs.