Tissue or mechanical?

[tobagotwo]

The CE tissue valves made before anti-calcification treatments average 90% still in place after 18 years, 80% after 20. This is experiential, not estimation. As the average age of a recipient is in the sixties, that bias in the data needs to be considered. However, it means that these valves do have staying power. For someone in their fifties and beyond, ten years would be an unrealistically low valve lifespan estimate.

There is a big difference between young and old patients regarding this. There are many studies that display this, and there is a lot of data in past posts here. So while there are no good explanations provided, the difference itself is well documented. What's true for someone in their thirties has little bearing on the valve life expectation of someone in their fifties.

Having watched the US medical system for some years, even if the On-X trial is successful, the result in the US will likely be a compromise - a lower INR guideline, rather than an ACT-free one.

Best wishes,

 

[OldManEmu]

At 56 Years

At 56 Years

I agree with tobagotwo from my research at 56 any tissue valve will last more 10 years. With the exception of a tear, and this has a less than 1% probability. Any other issues within 10 years are not normally related to the valve construction.

 

[ALCapshaw2]

Having watched the US medical system for some years, even if the On-X trial is successful, the result in the US will likely be a compromise - a lower INR guideline, rather than an ACT-free one.

Best wishes,

To my Engineering Trained mind, the more interesting question is:
"What characteristics of this valve lead to the feasibility of NO or Lower Anticoagulation in the first place?"

That benefit would seem to be inherent in the valve itself and independent of the study result.

I believe I know the answers (there are several) but will leave that as "an exercise for the student".

'AL Capshaw'

 

[tobagotwo]

A few main features I can think of without going to look it up, Al...

• A soft closure that doesn't damage as many red blood cells

• a silicone-free pyrolytic carbon that is a slicker surface than other mechanical valves

• Curves in the structure designed to eliminate both turbulence and eddies in the blood current. Slowed or stopped blood coagulates by its nature.

The reasons I think they will likely not go with the no-ACT vote is that I believe the study was ony intended to get a reduced ACT permission in the first place, and the Americal medical community is partially owned by the American insurance industry. It's not really entirely about whether the valve could be used successfully without ACT.

Best wishes,