Valve type

[psalmist]

The surgeon recomended a carbo medics valve. He said he would have no problem using a st jude but that he has never put an on-x in and the day before on of his colleagues had some difficulty putting one in so he wasn't comfortable trying that one. He said he liked the carbo med valve because the ears on the st. judes made it sit further down into the heart. Anyone know about the Carbo med valve in camparison to the st. jude?

 

[Cooker]

Hi Seth,

Sounds like things are moving along for you. I don't know of any technical comparisons but I know they are both good choices. I really think it is the "surgeons favorite" that has a lot to do with the one you get.

Tom

 

[ALCapshaw2]

The surgeon recomended a carbo medics valve. He said he would have no problem using a st jude but that he has never put an on-x in and the day before on of his colleagues had some difficulty putting one in so he wasn't comfortable trying that one. He said he liked the carbo med valve because the ears on the st. judes made it sit further down into the heart. Anyone know about the Carbo med valve in camparison to the st. jude?

Did you ask Catheran Burnett for an Information Package? It contains sheets detailing Morbid Event Rates for ATS, CarboMedics, On-X, Medtronics-Hall, and St. Jude Medical Valves for both the Aortic and Mitral Positions. Note that the rankings are NOT the same for different positions but that On-X has the lowest Morbid Event Rate of those 5 valves for BOTH positions.

Also note that Catheran Burnett worked for CarboMedics for 7 years, St. Jude for 2 years, and On-X for 8? years. Before that, she was a Cardiac Surgical Nurse at Baylor (a MAJOR Heart Hospital). She can tell you WAY MORE than I about all 3 of those valves.

For the AORTIC position, the CMI (Carbomedics) valve seems to have a SLIGHT edge on the STANDARD St. Jude and the On-X has a slight edge on the CMI. It is my understanding that the On-X Valves need / use different "Sizing instruments" than the other Aortic Valves and perhaps this is why the surgeon at Mayo had difficulty. On-X will send a representative to meet with the surgeon to review the sizing measurements and even send someone to be in the O.R. to help with sizing IF REQUESTED.

For the MITRAL position, the On-X valve seems to have an even lower Morbid Event Risk than the other valves.

It is my 'understanding' that MAYO has been reluctant to include On-X as one of their primary offerings. (New Valves, Smaller Company, Higher Cost, pick one or more)

Call Catheran at 888-339-8000 ext. 265 or e-mail her at [email protected]

I recently posted the websites for all 5 manufacturers in the Valve Selection Forum. Let us know if you find someone at any of the other manufacturers who will divulge Valve Performance Data to a PATIENT.

Did you ask St. Jude about the HISTORY of the St. Jude REGENT Valve?
Did you ask about any reports of VALVE FAILURE of the REGENT?
You Really NEED to KNOW that information in making your choice.

'AL Capshaw'

 

[Natanni]

Hi Seth

It sounds like you did get a different doc than Nathan after all!

Call Beth Eichorn at Mayo. She runs the valve clinic at the Mayo and she is wonderful!! I believe she works with all the surgeons and she will offer you unbias info on ALL valve types. Ask her about the new group they are watching in Africia-very encouraging news for ALL mechanicals in the Aoritic position! We made an appt to see her specifically when Nathan was having a horrible time trying to chose a valve. She was a great deal of help to him. At that appointment, she gave us the link to this board Hank didn't know at the time that Mayo Rochester had their eyes on his little site

Nathan has the Carbomedics. He had no preferance between St Jude and Carbomedics. He wanted the On-X, but Mayo just wasn't using them yet.

Let me know if you want her number.

 

[gdfd]

Carbomedics

Carbomedics

Hello psalmist !

I met today my surgeon for the first time. He also recommended a Corbomedics valve. His arguments were the following:
- he knows well this type of valve;
- he likes it because the cusps open and close inside the valve (my understanding was that they aren't exposed);
- he saw some Carbomedics valves in reoperations and they looked very well (I suppose no calcification)

 

[Susan BAV]

Just my experience...

Just my experience...

Seth, your question is a good one.

Please don't think I'm recommending a tissue valve for you but I would like to relate my experience of two comparable valves, both fitting roughly into the category of what I was after:

I researched valves to what I felt was a reasonable point for me. I asked the surgeons, with whom my husband and I consulted, about the Carpenter-Edwards [fancy] bovine valve that had sounded good to me. The surgeon we ended up choosing said he liked the Medtronic porcine valve over the other one. Perhaps he had more experience with it; I don't recall. But he was the highly skilled and highly recommended "expert" whom we trusted and I decided his excellent decades of experience counted; so I was completely comfortable with what he recommended.

(Edit - From what I've read here, it's possible the Carpenter-Edwards valves were not small enough for me, which is something my experienced surgeon would have known.)

So perhaps you will find that the one valve you are wanting is safely comparable to the other one the surgeon is recommending. Best wishes as you make peace with your decision.

 

[Bina]

When I had my surgery I hadn't found this site yet.....so I did not even know about the Carbomedics valve or On-X valve.
My surgeon and I only discussed the St.Jude or tissue choices....he did say that there was something else that was being tried, but he was not comfortable using it on me without knowing long term results..
I think he sensed that I was just too freaked out anyway.

 

[Natanni]

Does anyone know when Seth's surgery is? I thought it would be in a couple weeks now, but I may have missed something!

 

[tobagotwo]

The Carbomedics valve is a goods valve. So's the St. Jude. The On-X does seem to have an edge, overall.

However, the reason these surgeons apparently like the Carbomedics valve is because it's easy for them to put in. Not the surgeon I'd want.

There's no polite way to say it:


The surgeon puts the valve in once. You use it for the rest of your life.

If your surgeon isn't confident enough to put in the valve you want, get a better and more experienced surgeon.


Best wishes,

 

[psalmist]

hello

hello

My surgery has been moved from sept 24 to Oct 2nd. The surgeon did not mention anything about easier. He said he would be perfectly happy putting the st judes in. He left that up to me. He recomended the Carbo because it fit into the aortic root better than the st judes. The st. judes just petruded out further because of the ears. No functional differences from what I understood. The on-x problem they had was that after getting the On-x most of the way in they had a problem with finishing the sewing and had to remove it and ultimately put a different one in. He did not say anything negative about the valve at all. He said One of my colleagues had this problem and I have never put one in. I would not want to risk that as I have never inmplanted one. I appreciated his honesty and frankness. He had nothing negative to say about any of the three valves we discussed.

 

[Cooker]

Seth,
Sorry to hear things got pushed out.....but it sounds like you have everything well in hand. You will be over the mountain before you know it.
Tom

 

[Mary]

I've now got you on the calendar for October 2; if anything changes, please let us know.

 

[Bina]

Well, Seth, look at this way......you have another week to play in the sunshine with the kids.

 

[Natanni]

Thanks for the update Seth. Take care and keep us posted on how you are doing!

 

[ALCapshaw2]

The surgeon did not mention anything about easier. He said he would be perfectly happy putting the st judes in. He left that up to me. He recomended the Carbo because it fit into the aortic root better than the st judes. The st. judes just petruded out further because of the ears. No functional differences from what I understood. The on-x problem they had was that after getting the On-x most of the way in they had a problem with finishing the sewing and had to remove it and ultimately put a different one in. He did not say anything negative about the valve at all. He said One of my colleagues had this problem and I have never put one in. I would not want to risk that as I have never inmplanted one. I appreciated his honesty and frankness. He had nothing negative to say about any of the three valves we discussed.

Out of curiosity, I called On-X (1-888-339-8000) to inquire about the installation problem you mentioned Seth. I was told that On-X recommends 'tacking' the sewing ring at 3 or 4 places to immobilize the ring *before* sewing around the ring. Starting at one point and stitching sequentially around the sewing cuff is NOT recommended.

That, and a different way of 'sizing' the valve compared with other mechanical valves, is why they (On-X) prefer to have a representative meet with the surgeon *before* surgery. They will even send a representative (one is a former surgical nurse) to be present in the O.R. if the surgeon and patient are willing.

Best wishes for your upcoming surgery!

'AL Capshaw'

 

[Bad Mad]

I know we've been through this Al, but your last post really takes the biscuit

"Out of curiosity" you called ON_X to find out about an installation problem in an individual case?! Many people on here have an interest in the valve and many have it implanted. But no-one is any way near as obsessive about it as you. Every/Any time a person puts up a reasonable objective argument that in any way is a con of the ON-X valve you do everything possible to hammer home an explanation to the contrary. And often, that is that.

I accept that you are NOT a rep. for ON-X, but I do find your need to put a counter argument to everything said, a little strange. Old ground I suppose.
Maybe I just can't resist having a pop at you, I don't know

I can understand that perhaps you do truly believe in this valve and have a mammoth amount of info to back this up, but you have to admit you do use a hell of a lot of ON-X's in each post!!

 

[Mary]

I know we've been through this Al, but your last post really takes the biscuit

"Out of curiosity" you called ON_X to find out about an installation problem in an individual case?! Many people on here have an interest in the valve and many have it implanted. But no-one is any way near as obsessive about it as you. Every/Any time a person puts up a reasonable objective argument that in any way is a con of the ON-X valve you do everything possible to hammer home an explanation to the contrary. And often, that is that.

I accept that you are NOT a rep. for ON-X, but I do find your need to put a counter argument to everything said, a little strange. Old ground I suppose.
Maybe I just can't resist having a pop at you, I don't know

I can understand that perhaps you do truly believe in this valve and have a mammoth amount of info to back this up, but you have to admit you do use a hell of a lot of ON-X's in each post!!

I mean this in the nicest way, but Mad, with this post, it appears to me (maybe no one else) that you are starting to fixate on Al's motivation a tad much. If Al chooses to call the company, what difference does that make? I would say about as much difference as your choosing to comment on it. I don't think it's a big deal in the greater scheme of things.
IMHO!

 

[Bad Mad]

I mean this in the nicest way, but Mad, with this post, it appears to me (maybe no one else) that you are starting to fixate on Al's motivation a tad much. If Al chooses to call the company, what difference does that make? I would say about as much difference as your choosing to comment on it. I don't think it's a big deal in the greater scheme of things.
IMHO!

"If Al chooses to call the company, what difference does that make? I would say about as much difference as your choosing to comment on it."


But you see thats my point, I from time to time like to get involved in some of the discussions about On-X. I do not hi-jack every valve discussion, nor do I continuosly leave the same contact details of a company. Let me put it another way.

Al, provides a very strong and valid argument for the ON-X. He is obviously a strong and articulate individual who makes his point very well. Sometimes we lack a similar presence who can provide us with a counter argument that can help us attain a more objective/balanced view. I do feel that whilst his points have to be welcomed and can be very helpful/informative, they are always extremely one sided. Quick to mention examples (not in name) of horror stories of other valves but never points to any weaknesses of the ON-X, or any examples of recalls etc.
Of course people must make their own minds up, but whether we like it or not, we can be easily influenced by what we read. I'm sure if my cardiologist was on this board he could list examples of why the 11 year life-span of the ON-X is a reason on its own to be sceptical of it's long term success.

Me, I'm just another punter who wants to make the best possible choices, and be able to provide examples of experiences and pieces of literature that may help others on their way too.

it appears to me (maybe no one else) that you are starting to fixate on Al's motivation a tad much.

Perhaps you are right, but my comments on his motivation are sometimes more tongue in cheek. It's not as if I'm accusing him of having an affair!!

Al, knows that I am not JUST trying to 'have a go', and I'm sure he'll be along soon to put me in my place

 

[Susan BAV]

Too much...

Too much...

Out of curiosity, I called On-X (1-888-339-8000) to inquire about the installation problem you mentioned Seth. I was told that On-X recommends 'tacking' the sewing ring at 3 or 4 places to immobilize the ring *before* sewing around the ring. Starting at one point and stitching sequentially around the sewing cuff is NOT recommended.

That, and a different way of 'sizing' the valve compared with other mechanical valves, is why they (On-X) prefer to have a representative meet with the surgeon *before* surgery. They will even send a representative (one is a former surgical nurse) to be present in the O.R. if the surgeon and patient are willing.

Best wishes for your upcoming surgery!

'AL Capshaw'

Actually, I thought Al's comment and/or actions were, putting it mildly, strange... and nearly posted such last night when I first saw this presumption to judge and proclaim in such a manner what error surgeons may (or may not) have made, from his reading a brief paragraph.

Among other things, it reads to me here, Al, you may be putting yourself and what little you've learned over the vast experience of a heart surgeon. You are reportedly an engineer and have really embraced learning how this all works and that's terrific...

But I've thought a few of your posts to Psalmist have been extremely pushy in regard to the On-X valve.

 

[Cooker]

Let's Settle This !!!!

Let's Settle This !!!!

The absolute best valve available is pictured below. End of argument
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