redo after 7 years with CryoLife SynerGraft

[srwieland]

Hi all!

Some of you old timers may remember me as Steve in Florida from some years ago. I had AVR in May 2001 notable for getting a CryoLife SynerGraft homograft.

My first 8 months was great and then after that I began to develop leakage again. I have progressed from mild to moderate leakage over the last 7 years, but after a wonderful trip to Italy last summer (where I apparently overexerted myself!), I developed pulmonary edema (fluid in the lungs) and have been on a diuretic (furosemide) ever since.

Now, my left ventricle size has increased to 6.9 cm and my EF decreased to 40-45% and my cardiologist says it is time to redo.

My surgeon does not know why my CryoLife SynerGraft homograft is failing because he has detected zero calcification (as it was designed to resist) and only slight dilation. He thinks maybe it is because it was a pulmonary valve placed in the aortic position. Of course, he won't know for sure until he gets inside to see it directly.

First question: does anyone else have experience with or information about durability and problems with CryoLife SynerGraft valves? My surgeon tells me after some years resolving some issues with the FDA that it is being reapproved by them.

Second question: does anyone have experience with or information about the On-X valve by MCRI? I am considering it for my new valve as well as a clinical trial for low anti-coagulation therapy (i.e., aspirin and Plavix instead of Coumadin).

Thanks!

Steve in Florida

 

[Phyllis]

Steve, I have no information about the CryoLife, but there are many here who have had the ON-X and I am sure they will join in soon. In the mean time put in a search for "On-X" and you will come up with many threads.

 

[ctyguy]

Steve in FL...

Im 4 weeks post-op with an On-X in the Aortic position. Im 42 yrs old and decided I wanted mechanical with the hope that my OHS will be the only OHS I ever go through, time will tell on that. My decision for the On-X was two fold. The flow dynamics seem to be the most advanced of all valves and supposably has the lowest clot formation, that was the biggest thing to me. Plus the fact that my surgeon, Gosta Pettersson at the Cleveland Clinic, told me that if he was having a valve replacement that this is the valve he would want. The clinical study for elimination of Coumadin is a bonus in my mind if it ever happens but I didn't factor that into my choice. If you do go with an On-X the only advice I would give is find a surgeon who has installed one before. This valve is supposably more difficult to install due to the higher profile of the valve. That is according to my surgeon who has done over 50 of them. Not entirely sure what that means but I was very confident about my surgeons capabilities and thus far I have no regrets to my decision.

Good luck to you !

 

[Mary]

Steve,
You probably remember John Cochran.
Here's a link to a thread concerning his tribuations with the CryoLife Synergraft. http://www.valvereplacement.com/forums/showthread.php?t=13782&highlight=CryoLife
Best of luck with your replacement.

 

[Bonzo Dog]

Now, my left ventricle size has increased to 6.9 cm and my EF decreased to 40-45% and my cardiologist says it is time to redo.

Steve in Florida

Hello Steve in Florida, well bro I too have a failing homograft and a left ventricle of 6.8 cm so you win by a mm

My surgeon does not know why my CryoLife SynerGraft homograft is failing because he has detected zero calcification (as it was designed to resist) and only slight dilation. He thinks maybe it is because it was a pulmonary valve placed in the aortic position. Of course, he won't know for sure until he gets inside to see it directly.

Steve in Florida

This troubles me. Have you not had either or all of echos, MRI and CT scans to give the surgeon a picture of what is amiss? It sounds a bit gung ho to get in there unprepared and play it as it happens.

 

[hensylee]

Hi Steve. Just dropping by to say hey and yes, we do remember you. Sorry that you're having some problems again. Blessins...........

 

[Nancy]

Hi Steve-

Sorry this has happened to you. We always hope that our older members are just popping in again to say, "Hi", and not with a problem.

I guess from what I read, you had 8 good months, and then a slow and steady decline, and now a redo is looming. But this should fix the problem, right?

 

[Susan BAV]

Hi Steve -

I'm really sorry to read this. Something about what you wrote raised a red flag in my mind though, maybe a bit like how Bonzo Dog phrased it. And why were there eight good months?

Has your doctor done a TEE on you to check for pannus formation or valvular strands? I really don't know much about those two issues but I've read a few things here and maybe it's something you might want to look into. A member here, Arlyss, has posted some information on both, and that might be a good place to start reading about it, by doing an advanced search.

I hope your doctors figure out the problem. Please post again and take care.

 

[srwieland]

Thank you all so much! I certainly remember some of you who helped me so very much years ago, such as hensylee, Nancy & Joe, John Cochran, Hank & Ross of course, and so many others.

I'm sorry I stopped frequenting this site during the time that I was doing relatively well, but, as they say, friends in need are friends indeed! I feel selfish but, at times like these, there's just God, Mama, & VR.com!

Thanks especially for the advice, information, & links, which is what I remember being so great about the group on this site. I'm following up on all of your input. We just can't get that kind of feedback from anywhere else, certainly not from the doctors or medical device manufacturers (with whom I am very familiar, having worked professionally for many years as a medical research administrator).

Poor John Cochran lasted even less time than me with the SynerGraft; seems like the genetically flushed tissue must suffer some structural integrity. That's what my surgeon suspects from what he has seen so far, especially because of the very gradual decline and absence of rejection evidence in my case. I have had a TEE and many echocardiograms leading up to my current situation, but never an MRI or CT scan. My cardiologist feels that he knows enough already to conclude that I need to redo and can wait until the surgery to know for sure what is causing the SynerGraft to fail. (By the way, CryoLife is also very eager to find out!)

Yeah, anyway, Nancy, you're right, this time should fix it! (Or, so they say!) Approaching this second surgery for me is very mixed, though; on the one hand, it's better because I already know what I will be going through unlike the first time. On the other hand, already knowing what I will be going through unlike the first time makes it worse! At least, there was more bliss from ignorance on the first go around.

Hey Bonzo Dog, I lost the race with Hank (see his anniversary post), but it seems me and you are neck and neck at this point. What's happening with you? Are you up for a redo too?

Thanks again everyone! I'll be lurking and hopefully posting more these days and be catching up with what's happening with many of you as well.

 

[WayneGM]

Your last surgery was before my time here, so I thought I'd just say "Hi, and welcome back". Sorry to hear you're in need of a redo. Best wishes and good luck.

 

[Bonzo Dog]

Hey Bonzo Dog, I lost the race with Hank (see his anniversary post), but it seems me and you are neck and neck at this point. What's happening with you? Are you up for a redo too?

I'd like a redo, still all to be decided more info here http://valvereplacement.com/forums/showthread.php?t=24463&highlight=newbie

 

[ALCapshaw2]

Steve wrote:

"Second question: does anyone have experience with or information about the On-X valve by MCRI? I am considering it for my new valve as well as a clinical trial for low anti-coagulation therapy (i.e., aspirin and Plavix instead of Coumadin)."

For starters, see their websites: www.onxvalves.com and www.heartvalvechoice.com

You may want to also contact their Manager of Education and Promotion, Catheran Burnett, RN at 1-888-339-8000 ext. 265 or [email protected] She can send you an extensive information package packed with data sheets, study results, and comparision of 5 year performance vs. other mechanical valves.

Catheran is a former Heart Surgery Nurse (at Baylor when Dr. Debakey was there) and has worked for Carbomedics and St. Jude over the past 20 years. She "knows valves".

'AL Capshaw'