NEWBIE: Needs advice

[jeffp]

Or maybe the hospital contracts with one or the other.

Bing! Give that man a cookie.
It’s as simple as that. The purchasing person for the hospital gets input from the surgeons and sees what they can get the best reliable stocking at a good price, and goes with that. Price is less of a driver that you’d expect, the difference gets passed along in the billing. Often they lean heavily on a single supplier and that supplier relies on the repeat volume business. It’s symbiotic. I worked out of the orthopedic department at our local hospital and that’s the way it worked with joint implants, pins, screws, etc. I imagine cardiac hardware worked the same way.

 

[Superman]

I worked out of the orthopedic department at our local hospital and that’s the way it worked with joint implants, pins, screws, etc.

I think that’s the kind of stuff my neighbor sells, or reps, or whatever.

 

[BionicBuddy]

My Surgeon, #2 in the country told me that the only mech valve he uses is OnX;

Our surgeon on the other side of the country said the same thing. Maybe it's a Canadian thing.

When a surgeon who is going to split your chest open and put your heart on pause tells you that he only uses OnX, would put that valve inside himself if he had severe AS/BAV (he is 55), and would use that valve in himself if he were 64 (and athletic and fit), we aren't going to argue with him.

There are more than just studies that guide surgeons to do and choose what they do. Of course, they follow all of the guidelines and studies. But there is also long term clinical experience and that counts for something. He shared with us some of his experiences.

Canada is an extreme example of a country with socialized medicine. The ongoing discussions on this website regarding costs/influence/marketing/availability/etc. is much less a factor in our country IMHO.

 

[tom in MO]

My surgeon is #2 in the world

When asked about OnX vs. St. Jude, my surgeon said he would give me an OnX if I wanted but normally would use a St. Jude. He said the hospital stocks valves so they can have various sizes on-hand for emergency surgeries and they stock St. Jude. He could order me an OnX if I desired. He said he had a lot of experience with St. Jude and it's been around for a longer period of time and has proven to be a robust device over many years. I went with St. Jude because when I really thought it over hard, it was kind of stupid for me, a chemist, to even contemplate choosing a valve model since I am not an expert in heart valves.

 

[Superman]

My surgeon is #2 in the world

I can see you’re just making a funny.


Mine has moved a few times since 2009. He’s in Arizona now apparently. Or Oklahoma City. Seems to be a common surgeon name. He was in Florida for a bit too. I keep ticking with no issues.

I’ve never seen a ranking. How would they do that? By volume? Fewest lawsuits? Error rate? I know the top sales people are sometimes pretty rotten folks.

My first was done by the guy that pioneered OHS in my State. Not sure if that means they’re any good. Just means they went first. Someone had to.

I find surgeons are generally pretty good at surgery or they don’t become surgeons.

 

[W84Me]

Got new valve installed and it is working fine and I am still in the hospital. Came here for the catheter test but went into cardiac arrest and they found one of the arteries blocked 85% so now I need to be rest here and wait for the recovery hopefully it will be all fine and I got Onx alve installed that the doctor said was the best option available to me. Thank you so much for all.

 

[Gkeraney]

Got new valve installed and it is working fine and I am still in the hospital. Came here for the catheter test but went into cardiac arrest and they found one of the arteries blocked 85% so now I need to be rest here and wait for the recovery hopefully it will be all fine and I got Onx alve installed that the doctor said was the best option available to me. Thank you so much for all.

awesome! get all healed up and enjoy life!

 

[Survived03]

Got new valve installed and it is working fine and I am still in the hospital. Came here for the catheter test but went into cardiac arrest and they found one of the arteries blocked 85% so now I need to be rest here and wait for the recovery hopefully it will be all fine and I got Onx alve installed that the doctor said was the best option available to me. Thank you so much for all.

Well wishes to you W84Me. Follow the instructions forward and make a quick recovery. Glad you are on the other side.

 

[pellicle]

Came here for the catheter test but went into cardiac arrest and they found one of the arteries blocked 85% so now I need to be rest here and wait for the recovery hopefully it will be all fine

wow ... that's quite the ride.

So you've now had the OHS, did they do any bypass surgery?

 

[user 15848]

Well, he doesn't. I have said this before and I will say it again, the surgeon's are very good at anatomy and plumbing things but they know very little about function and details about prosthetic "X". Leaflet function of the SJM is superior to the OnX - but most surgeons are (sadly) overly influenced by the marketing dept of these corporations.

Well..... I never said this before, but i will say it once: IF a surgeon does not know anything about mechanics of fluids, not everybody needs to know, simply he can not choose a valve over other, Second, for some reason you are very defensive towards St Jude, got one ?, Third, OnX is an Improved Design over St Jude, but St Jude is also Good, and those are engineering facts., Do you have a St Jude? ..... or ....

 

[nobog]

And how do you know the OnX is an "Improved Design" ? Marketing claims, OnX reps, Dr. recommendations, and even fellow "users" on this site doesn't make it so. Lets just say I have personal experience in the industry.

 

[pellicle]

And how do you know the OnX is an "Improved Design"

 

[carolinemc]

Well..... I never said this before, but i will say it once: IF a surgeon does not know anything about mechanics of fluids, not everybody needs to know, simply he can not choose a valve over other, Second, for some reason you are very defensive towards St Jude, got one ?, Third, OnX is an Improved Design over St Jude, but St Jude is also Good, and those are engineering facts., Do you have a St Jude? ..... or ....

I have had my St. Judes' valve since 2001, so that is 22 years and still going strong. OnX is not better than St. Judes' for there have been problems with it since its introduction. Not being defensive, but surgeons know what works and will use what is a fit for you. And they know more about surgery than we do. They went to medical school and did 4 years internship.

 

[carolinemc]

And how do you know the OnX is an "Improved Design" ? Marketing claims, OnX reps, Dr. recommendations, and even fellow "users" on this site doesn't make it so. Lets just say I have personal experience in the industry.

Thank you, for they know more and you hit it on the nail. Not one is more better than the other, no matter who they are built and improved.

 

[pellicle]

Third, OnX is an Improved Design over St Jude, but St Jude is also Good, and those are engineering facts.,

can you cite those engineering facts that demonstrate the improved (not simply different) design changes please?

PS: I have an ATS and I don't usually recommend it, I recommend St Jude based on evidence and track records.

 

[pellicle]

They went to medical school and did 4 years internship.

and then a LOT more after that too.

 

[jcgtok17]

I am 58 and have been diagnosed with severe stenosis after undergoing ultrasound echo and have my first appointment with the cardiologist tomorrow (Monday, June 26).

So as I understand from this very resourceful forum, I will have the option of either tissue valve or mechanical valve. The latter being a one-time procedure but with lifelong dependence on blood thinner as well more vulnerability to infection. And the former being a 10-year (or so) treatment that requires repeat of open-heart surgery but with no medicine dependence.

Am I getting it right?

I have no health-related issues including hypertension, weight etc. Always exercised using weights and never smoked. Alcohol consumption was also very rare. No family history of heart-related problems. Quite frankly, I am surprised to find my diagnosis with stenosis.

I will pose three questions:

1. How long was the recovery after the surgery?
2. If you had tissue valve replacement, how long did it last?
3. If you were in my shoes, which valve option you will prefer? I would like to have as much back to normalcy as possible (including staying fit using weights if possible).

Thanks to everyone for helping me in the right direction.

1. Recovery was quick, 3 months tops. Age 50 tissue value. No other option discussed or offered up.
2. Just over 6 year so far. Slight murmur on last check up, signaling slight regurgitation (center of valve). Latest studies indicate 20 year valve life. IF 70 when replaced TAVI, if earlier OHS (scheduled).
3. Tissue valve. Staying fit and keeping weight off key to valve longevity.
Regards, JCG

 

[jcgtok17]

St Jude Medical Trifecta GT 27mm. Japan typical Edwards valve 21mm avg. FYI

 

[W84Me]

So now since I am able to function lilttle bit more here is the unexpected journey in brief:

I went for my cardiac catheter test on July 10 which takes about 50 minutes. Very early in the test my blood pressure dropped and I went into cardiac arrest. I was practically gone for a few minutes when they tried to revive me with electric shock and CPR. After 10 shocks I responded. Since my heart had stopped beating, we don’t know if there is permanent neural damages. My vision has taken a hit in not being sharp as well as unable to focus precisely.

I have been told by team doctors that it is a miracle that I am alive.

As for the valve, it is On-X. Presently the INR is 1.99.

So it was an open heat surgery with Pacemaker and defibrillator installed. Sutures will be removed on August 7

 

[jeffp]

Holy wow! That fact that you’re here, and able to put together coherent sentences and post them, means the powers that be are looking out for you. You’ve got a long road ahead after your ordeal (what a story to tell). Keep on progressing and sucking on that cursed repirometer.
Best wishes for a complete, and then some, recovery.