On-X vs. St Jude Mechanical valve

[perico75]

I already posted this but I guess that this would be a better place:

Having already chosen to go for the mechanical option for the Aortic Valve Graft Replacement I am basically looking at two alternatives:
1 - St Jude
2 - On-X
I read about the possibility that the On-X can tolerate lower levels of INR so my first reaction is to go for the On-X. Just wondering why St Jude did not adopt the same material as On-X considering that the ON-X got approval for lower INR?
My surgeon is OK with any of the two although he said that he does more of St Jude. He also mentioned that the effective area of the St Jude is a bit higher for same external diameters when compared to the On-X as the St Jude frame is a bit smaller.
Any thoughts about this?

 

[pellicle]

Wow, talk about revive the zombie thread 7 years old

I already posted this but I guess that this would be a better place:

But I see your reasoning, it's just uncommon in the modern internet

I read about the possibility that the On-X can tolerate lower levels of INR so my first reaction is to go for the On-X. Just wondering why St Jude did not adopt the same material as On-X considering that the ON-X got approval for lower INR?

Well they are made of the same materials. Its just that On-x needed some extra marketing to cut into a market well established by St Jude.

I was one initially interested in the On-x buOnmy surgeon installed the ATS because in Australia the on-x had yet to obtain approval for its version with the pre attached graft.

Every study I read suggests that all the bileaflet open pivot pyrolytic carbon valves are more or less identical with minor variations to avoid stepping in each others intellectual property rights.

Where one may have softer net pressures on openings, the other beats it on closure (for instance)

Essentially they are the same , only St Jude has the advantage that it is well proven to be consistently well made, with years of field evidence.

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Any thoughts about this?

Above.

 

[Agian]

The only advantage the On-X has over the St Jude's is that it has a Pannus guard, making pannus unlikely. The trade off is a smaller orifice. The lower inr stuff is probably just fluff. I have an on-x and am happy to sit over 2.5,

"Pannus is a pain in the arse/***." Can you see the pun? That's cringeworthy cardiologist humour.
Here's another classic: "Do you know why they call it the aorta?... Because I oughta not not cut it." (Face slap)

 

[perico75]

Hi Agian,

The only advantage the On-X has over the St Jude's is that it has a Pannus guard, making pannus unlikely. The trade off is a smaller orifice. The lower inr stuff is probably just fluff. I have an on-x and am happy to sit over 2.5,

Now it is pretty clear to me why my surgeon told me that for a certain outside diameter the St Jude had higher effective surface than the On-X. And it seems that more surface = better. Does anybody know why is that?
Thank you!

 

[Agian]

Bigger diameter = less pressure across the valve, which is better for the heart. Remember the whole purpose of replacing the thing is to reverse the high gradients and improve flow.

 

[ClickityClack]

... I read about the possibility that the On-X can tolerate lower levels of INR so my first reaction is to go for the On-X. Just wondering why St Jude did not adopt the same material as On-X considering that the ON-X got approval for lower INR? ...

I believe the deposition process for the pure pyrolytic carbon was patented: http://www.google.com.pg/patents/US5284676

My understanding is that the other valves use the older manufacturing method that alloys silicon with the pyrolytic carbon to obtain the required durability and toughness. The pure pyrolytic carbon is supposed to be smoother and therefore less thrombogenic - at least according to Cryo-Life.

As for lower INR, I can only offer my own experience. I've been managed between 1.5 and 2.0 for nearly two months now with an On-X aortic valve. I should be seeing symptoms by now if it were an issue.

 

[zee112]

Mine is a Carbomedics Carboseal. I think they are very similar to St Judes? Not sure

 

[tom in MO]

I brought up the Onyx 5-years ago and was given a choice. My surgeon said he preferred the St. Jude because of it's proven track record; I didn't assume to know more than him.

Mine is aortic, and the St. Jude INR range was dropped from 2-3 to 2 - 2.5 just before I received it. When my INR dropped low a few times and when I had to go off warfarin for a few days for a TURP, my cardio said not to worry, the St. Jude can handle it based upon it's long history of success. He was right, no stroke yet