ok, well firstly I'll assume that was a typo because the maths makes it 13 years
Next its important to know that the primary site sponsor was On-X back in those days, there were no other ads. Hank started the site as an independent entity and had a St Jude himself. Ross was an important member before my time here and spent many a time doing (what is sadly missing here) the role of moderator when valve bashing got out of hand.
Accordingly its no surprise that On-x features strongly in these discussions.
When thinking about this topic you should adopt a stance that encompases:
- how can you possibly inform yourself to know yourself if what you hear is correct or not correct (magic with no substance or a position supportable with hard arguable data)
- the difference between marketing fluff and bio-engineering pragmatism
- proper knowledge of the words used and what the differences are (like in vitro and in vivo)
- knowledge that these are not consumer products (like washing machines or stereo units) and accordingly must pass entirely different standards to even be presented to "the market"
I already gave you a link in a previous topic which contained measurements and comparisons (in vivo) on the opening and closing and valve area of all valves, which also contained their marketing claims and their actual performance as measured. Did you read that? Did you understand that? Because if you did I'd wonder why you're even asking this question again.
Only one of us here to my knowledge has the actual experience in this to make a call and that poser will (intelligently) not tip his hand as to why for a number of reasons including non-disclosure binding contracts (meaning don't push them to disclose). That person does post small and subtle posts here from time to time and IMO when they speak you should choose to listen.
There is only one other topic which matters on the choice of a valve which you may not have picked up and that the pressures at tiny instants of time called "opening and closing jets". The computational fluid dynamic modelling of that shows that you can tune for better pressures on opening, but you get worse ones on closing (and vice versa).
Why is this important? Well triggering platelets to go into "aggregation mode". Why is that important? Well because that's what is the major cause of thrombosis formation as it passes through the valve. This aggregation will go up and into the blood from the aortic valve where it will be within inches from your brain .. which is probably the last place you want a clot to form right?
I can give you studies to read on this but can you follow them and how long have you got?
Lastly I'll ask you to look in the mirror and ask yourself "is this some sort of cunning trick of your unconscious to avoid thinking about what you need to think about or to avoid thinking about what you don't want to think about"? I mean that's ok, but now you should be seeking peace of mind and settling yourself in to commit to the ride and think about your family.
I have two blog posts which I think are of significance to you right now, this one was written in 2014 (which would be clear from the date if people looked at URL's)
http://cjeastwd.blogspot.com/2014/01/heart-valve-information-for-choices.html
in that what I think is important to you is right at the bottom, I'll paste it here:
Anyway, enough about you, think for a moment about your family.
My wife was distraught at the thought of my surgery (more so than me), she was beside me every step of the way. She said to me in recovery that some of the happiest moments of her life were in seeing me get better every day.
She put on a brave face, but the fact is that she was scared shitless that I would die and she would be left without me.
She was so pleased because she was so relieved. I would not want to put her through that again. If you are a reasonably healthy adult, and you choose a tissue valve you will for sure be putting your loved ones through it again.
Is that something you want to do to them?
The next post is this one, which was written just prior to surgery
http://cjeastwd.blogspot.com/2011/11/heart-of-matter.html
You can see that at that time I knew very little about the current crop of mechanical valves and wrote what I did about the On-X ... I addressed that point like this:
The other choice that the surgeon seems to be considering will be the one from ATS Medical (also pyrolytic carbon). Since he (rather than me) has more experience in this matter (implanting valves) I'll be relying on him to make the final choice "when he's in there and sees what he finds".
so while I did a little reading on the valves (
he did suggest the On-X as the other possibility) I knew far less then than I know now over 10 years later. Note that I genuinely felt that I would rely on him to make the better choice than me. He made the choice of valve based on exactly that criteria "ease of implanting" (which is not trivial because reducing time on the pump is critical). He also made it for another reason which related to management of INR.
What I know now is that I'm glad I got the ATS (having seen an On-X) ... simply because its huge compared to the dainty and delicate St Jude or ATS (I expect that comes from the Pannus Guard feature).
Lastly let me give you a metaphor, as it happens I know quite a lot about Stereo Gear from the technical perspective (and was involved in the HiFi industry for a short time). What I saw there was that utter twaddle that was un-supportable critically was marketed to people with "more money than sense" with "outright lies" often told. Ultimately people were to me deaf and relied on what salesman told them. Yet in the Audio Industry (PA, Concert, Studio Recording) there was less of that and brands that the consumers never knew existed were the mainstay of actual industry.
Basically you can't "go wrong" with either choice, and when its in (as I said before) what will matter in the long term is your INR management, not the valve.
Best Wishes
that is a great way of saying it!!
