on-x vs. st. jude

[sfconstrct]

I am a healthy and fit 50 year old, athletic. I will most likely be scheduling a AVR in mid Feb. 06. I have a very good cardiologist and believe he has referred me to a very well known surgeon, Dr. Yokoyama in Los Angles, St. Vincents. I believe he prefers the St. Jude although I haven't met with him yet. I am hearing about the newer mech. valves, in particular the On-X. They appear to be quieter and the biggest advantage is that they have substantial studies indicating that someone in my case would only have to be on asprin and be able to forgo cumidin. According to their lituture they have installed over 30,000 units and had no problems to date. Anyone out there have any more info. Don't know to go with the new dog on the street or tried and true.

 

[Emma]

My 6 year old daughter had an On-X mitral valve replaced in June 2001 and we love it.

It is supposedly one of the best valves around and is undergoing trials for aspirin only - although I do stress they are only trials and it'll be quite some time yet before anything conclusive comes from them so you'll need to be basing your decision on their and others valves claims that can be proven now - if you see what I mean?? (rushing here as I have to go cook, lol).

Have you tried the On-X makers website for more info??
Its ...

www.mcritx.com

Good luck with your decision
Emma
xxx

 

[Ross]

Either way, you cannot go wrong. On-X is coming up the ladder, but as Emma said, it's going to be a long time before you won't have to be anticoagulated. To get into the testing program is very tough also. Not sure I would want to be in the test category anyhow. My idea of this surgery is to save my life, not possibly cause me to be a vegetable because of stroke from lack of anticoagulant. If your seriously considering mechanical, please visit Al Lodwicks site at www.warfarinfo.com and study up on Coumadin. There are so many b.s. stories floating around about Coumadin that the drug gets an unfairly bad rap and most of it is untrue.

 

[sfconstrct]

st. jude or on-x

st. jude or on-x

I am a healthy and fit 50 year old male. It appears that I will be getting AVR within the next month or so. Although I haven't met with my surgeon yet ( getting angiogram Thursday) Dr. Yokoyama, (St. Vincents) Los Angles, my cardiologist ( D. Kawanishi) said he uses the St. Jude mech. valve. I have heard and read some information about the on-x which I understand are quieter. However my biggest reason to consider the on-x is that they have an asprin study that indicates that I would probablly be on asprin and not need cumidin which is a big plus. Anyone have any thoughts or experiance with the on-x would be appreciated. Stay with the tried and true or go with the new dog. Peace! s.r.f. In So. Ca.

 

[sfconstrct]

on-x st. jude

on-x st. jude

thanks guys and girls, actually the reason I know about the on-x is a friend and fellow basketball player works for them and suggested I take a look at his product, he thought that since I am reletively young and in very good shape I would be perfect for the asprin therapy. I will of course talk to my Cardiologist Kawanishi, and Surgeon Dr. Yokoyama. Thx. peace! s.f.

 

[Ross]

Please post the question in only one forum. We read all forums and multiple postings of basically the same question only gets multiple answers from the same folks. It keeps it neat and orderly to find answers to topics also when using the search feature.

 

[RCB]

The ON-X may prove its claims to be a superior valve, but right now who ever
told you this:

"they have substantial studies"

Does not know what they are talking about. If you could post said studies, it woulld be news to me.

As Emma has stated there are only trials.

What is never stated by these company but documented by many doctors is that people can get along well with no ACT for years with out a problem. I personally went for 7 years without warfarin in the early days, with a prototype valve. Al Lodwick tells of a man in Turkey who went 25 years on an early valve with no ACT. Then there is the unlucky soul who leaves the hospital with the newest valve and is on ACT, but gets a stroke.

There will be a collective cheer from all of us, even the tissue valvers if indeed ON-X or some other mech. valve proves ACT unnecessary, but the data isn't there yet or in the near future.

 

[Ross]

See Moo's post about this:

http://www.valvereplacement.com/forums/showthread.php?t=12696&highlight=ON-x

 

[tobagotwo]

Any of the top brands of mechanical valves at this point are excellent choices. The St. Jude valve is the most used, and is owned by the vast majority of mechanical valve recipients on this site.

My personal favorite of the current mechanical valves is the On-X, due to its low damage to blood cells and its resistance to clotting and tissue growth. But I have a porcine valve, and no skin in the mechanical game at this point.

I strongly suggest that you not go with the On-X just because you believe you will wind up only taking aspirin. If the aspirin ACT is eventually approved for the On-X (and it may not be), it will take years. We all sincerely hope for it, but it will have to prove out for the FDA first. If you go for it, do so because you have studied the brands, and have chosen it for the features it can legally advertise at this time.

It's unlikely you will be able to get into an aspirin trial. And if you don't, your doctor will not start you out on aspirin anticoagulation therapy in 2006. He will start you out on warfarin (Coumadin), regardless of the brand. If he didn't, his malpractice insurance would drop him, and his peers would shun him. When you make your choice, you should bear this in mind.

Best wishes,

 

[Randy & Robyn]

The FDA has finally approved a reduced anticoagulation trial for the On-X in the U.S. and have posted it on their site.

http://www.onxvalves.com/

No other information yet. Be aware this is NOT an aspirin trial. It will probably involve a lowered inr in the range of 1.5 - 2.5. Maybe someone else here has more information, but I recall hearing something about a similar trial with the St. Jude a few years back that didn't pan out. Anybody's guess if this one will turn out better or not. I wouldn't think the FDA would want to risk another trial if there wasn't good evidence it might succeed.

It does indicate the next step is being taken toward aspirin therapy with the On-X which, as others have stated, is still years away if it happens at all.

Randy

 

[sfconstrct]

repair

repair

Randy, what were the circumstances in regards to your aortic repair? I have a bi-cuspid and assume it can't be repaired. Severe stenosis and regurg as well. Thanks for the comments. So it sounds like most all don't put alot of solis in the asprin claims from On-X. Thx. Steve

 

[Dustin]

I am a healthy and fit 50 year old, athletic. I will most likely be scheduling a AVR in mid Feb. 06. I have a very good cardiologist and believe he has referred me to a very well known surgeon, Dr. Yokoyama in Los Angles, St. Vincents. I believe he prefers the St. Jude although I haven't met with him yet. I am hearing about the newer mech. valves, in particular the On-X. They appear to be quieter and the biggest advantage is that they have substantial studies indicating that someone in my case would only have to be on asprin and be able to forgo cumidin. According to their lituture they have installed over 30,000 units and had no problems to date. Anyone out there have any more info. Don't know to go with the new dog on the street or tried and true.

The On-X appears to be a good valve, like St. Jude and ATS. From what I read there are some differences, though, because the On-X is the only valve that opens 90 degrees, claiming to reduce turbulence induced thrombosis. Also, the On-X does not have traces of silicon, so it is truly a carbon product. From these charateristics it is argued that the On-X shows signs of lower clotting risks.

My take on the mech valves is this: The St. Jude is the Mercedes Benz among valves. So, if you are classical minded and look for a robust, reliable and proven solution, choose the St. Jude. If you are willing to look at alternatives, such as newer BMW models, choose On-X.

 

[Randy & Robyn]

Randy, what were the circumstances in regards to your aortic repair? I have a bi-cuspid and assume it can't be repaired. Severe stenosis and regurg as well. Thanks for the comments. So it sounds like most all don't put alot of solis in the asprin claims from On-X. Thx. Steve

My valve repair has been a nightmare, Steve. Two weeks out from surgery, they heard a murmur and found that I once again had severe leakage from the valve.

As to what went wrong, first they thought it was endocarditis. Then they thought it was just a failed repair. Then they came back with the diagnosis of endocarditis caused by brucellosis. Now they are having their doubts about that. Suffice it to say that I won't know until they crack me open again which is coming very soon.

I had pure regurgitation and no stenosis which is supposedly the ideal situation for a valve repair. However, aortic valves are notoriously more difficult to repair than mitral valves. The vast majority will have to be replaced sometime in the future anyway. The exception would be when the regurgitation is caused by an aneurysm. Those repairs have a much greater chance of lasting a lifetime.

Randy

 

[Geo]

Randy,

sorry to hear about that. You have our support and prayers for your upcoming surgery. Just curious, have you decided which valve you will go with?

 

[Randy & Robyn]

Randy,

sorry to hear about that. You have our support and prayers for your upcoming surgery. Just curious, have you decided which valve you will go with?

My cardiologist is suggesting I go with a homograft because of the possible endocarditis. However, I want a mechanical valve so I don't have to go through this surgery yet another time. Once was enough. Twice is pushing my luck.

I asked my surgeon at Cleveland Clinic about the ATS and On-X. The ATS is available there. But I am holding out hope I may convince him to use the On-X. The company that makes it is actually in negotiations with them at the moment.

 

[PapaHappyStar]

My cardiologist is suggesting I go with a homograft because of the possible endocarditis. However, I want a mechanical valve so I don't have to go through this surgery yet another time. Once was enough. Twice is pushing my luck.

I asked my surgeon at Cleveland Clinic about the ATS and On-X. The ATS is available there. But I am holding out hope I may convince him to use the On-X. The company that makes it is actually in negotiations with them at the moment.

Hi Randy,

Just read your pre-holiday update thread -- glad you may have the opportunity to get a mechanical valve which looks like the optimal solution and Dr. Pettersson a very good choice for you.

I think all will go well for you -- you have the courage to pull this through.

Regards,
Burair

 

[RCB]

My cardiologist is suggesting I go with a homograft because of the possible endocarditis. However, I want a mechanical valve so I don't have to go through this surgery yet another time. Once was enough. Twice is pushing my luck.

I asked my surgeon at Cleveland Clinic about the ATS and On-X. The ATS is available there. But I am holding out hope I may convince him to use the On-X. The company that makes it is actually in negotiations with them at the moment.

Randy, Had I the choice, I would have gone with the ON-X. They(CC)
had the St. Judes Regent, but not for the mitral position which I need. I think it is great that you are pushing them in that direction. Your surgeon
is one of the best and I am sure you will do well.

 

[Randy & Robyn]

Randy, Had I the choice, I would have gone with the ON-X. They(CC)
had the St. Judes Regent, but not for the mitral position which I need. I think it is great that you are pushing them in that direction. Your surgeon
is one of the best and I am sure you will do well.

Thanks, Bob. I know I will be in the best hands I can be.

I have my fingers crossed that they will allow me to have the On-X. However, there are politics involved.

This is a quote from a rep at MCRI, the manufacturer for the On-X that I have been in contact with: "the valve business at the Cleveland Clinic is done by tender which means they only contract with certain companies for their business every year. It is usually based on lowest price."

I would be very interested in knowing what an On-X sells for compared to a Carbomedics or St. Jude.

Randy

 

[tobagotwo]

That's very interesting news about CC, Randy.

No wonder they go with the Edwards products. I had originally thought it was because some of the doctors have had product development relationships with Edwards.

The reason may be much more mundane. The Medtronics Mosaic is the most expensive tissue valve on the market, a pièce de cochon on a Rolls Royce budget.

I wasn't aware that they actually limited the selections. I am not a fan of efficiency over choice. There's certainly enough valve business at CC for everyone.

Best wishes,

 

[Randy & Robyn]

I received this update on the On-X aspirin trial. The manufacturer says it still looks promising. They are at 37.6 patient years and have had one death (a patient who had other risk factors and should not have been included in the trial to begin with), one TE and one TIA by my count.

Any comments?

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