I cant have an ON-X?

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J

Joecb

I am scheduled for surgery next week. I called my Dr. a week ago and said that I'd like to with the ON-X valve. My primary reason is that I am interested in moving to a lower dose of warfarin. I get a lot of bumps and bruises in my line of work. He said that the ON-X wont work for me because I need the the aortic root replaced (I had a previous aortic replacement and now have an aneurysm). Apparently, I will be getting a St. Jude w/ conduit instead. I'm wondering why it is necessary to have the St. Jude w/ conduit instead of having the ON-X and then attaching a conduit? I would have asked myself, but was relayed the info from an assistant. Thanks.

Joe
 
Many surgeons do attach dacron velour sleeves to the On-X (or other) valves. There's nothing preventing it. It's considered safe and effective.

It's your surgeon who doesn't. He's apparently not comfortable with doing it, or with the extra pump time, or doesn't want to spend the extra time on your OHS. He may have a tight operating schedule. The SJM comes preassembled and pre-checked, saving time and effort for the surgeon.

It will leave you longer on the bypass to have the On-X and sleeve cobbled together on the spot, as it extends the amount of time the operation takes. However, there are folks here who have had it done. Sounds like if that's what you really want, you'd need to go with another surgeon who's willing to go the extra distance.

Best wishes,
 
Joe, when is your surgery date?- We would like to put you on the calendar so we can cheer you over this mountain.
 
Joecb said:
I am scheduled for surgery next week. I called my Dr. a week ago and said that I'd like to with the ON-X valve. My primary reason is that I am interested in moving to a lower dose of warfarin. I get a lot of bumps and bruises in my line of work. He said that the ON-X wont work for me because I need the the aortic root replaced (I had a previous aortic replacement and now have an aneurysm). Apparently, I will be getting a St. Jude w/ conduit instead. I'm wondering why it is necessary to have the St. Jude w/ conduit instead of having the ON-X and then attaching a conduit? I would have asked myself, but was relayed the info from an assistant. Thanks.

Joe
Click to expand...

Joe:
Depending on your age have you considered a tissue valve and get rid of the warfarin all together! The Medtronic Freestyle Porcine valve includes the ascending aorta, valve, and coronary artery stubs all in one piece. However a lot of surgeons don't like to use it as you have to stay on the pump longer.
I had mine installed at Stanford University Hospital as they had experience with Marfans. Maybe you could find a University hospital near you and get a second opinion! :)
 
I'll bet that Catharan Burnett at On-X could give you the names of several Surgeons in Texas who can and would implant an On-X valve and attach a conduit.

Give her a call at 888-339-8000 ext 265.

FWIW, she worked as a Surgical Nurse at Baylor and On-X is located in Austin (TX).
 
Just wanted to pipe in and let you know that I had my ascedning aorta, root and aortic valve replaced. I have an On-X valve - It can be done!

I was my surgeon's first ON-X patient and now it is his favorite mechanical valve!

There is a fine line regarding insisting on what you want and asking your surgeon to do something he isn't comfortable with. My suggestion is to find out why he is hesitant and based on that info possibly look for another surgeon who is willing.

Good Luck!
 
Joecb said:
I am scheduled for surgery next week. I called my Dr. a week ago and said that I'd like to with the ON-X valve. My primary reason is that I am interested in moving to a lower dose of warfarin. I get a lot of bumps and bruises in my line of work. He said that the ON-X wont work for me because I need the the aortic root replaced (I had a previous aortic replacement and now have an aneurysm). Apparently, I will be getting a St. Jude w/ conduit instead. I'm wondering why it is necessary to have the St. Jude w/ conduit instead of having the ON-X and then attaching a conduit? I would have asked myself, but was relayed the info from an assistant. Thanks.

Joe
Click to expand...

Hmmm.... I can't help but wonder,
Did you have a Bicuspid Aortic Valve?

If so, it sounds like your first Surgeon didn't check out your aorta / tissues for possible signs of Connective Tissue Disorder.

If you have a Connective Tissue Disorder, you might want to verify that your surgeon has considerable experience dealing with those issues and surgery of the Aorta.

Dr. Coselli and Dr. William Ryan come to mind as frequently mentioned Top Surgeons in Texas.

'AL Capshaw'
 
Where are you located in Texas? There are excellent surgeons that deal withthe On-X in Dallas and/or Houston.
 
Joe -

I contacted Catheran Burnett, RN, at On-X about your situation.

Here is her response:


While the number of surgeons in Texas that have constructed the valve/graft device with On-X is limited, there have been hundreds constructed across the USA without extra complications for the patients reported to us. Our own preassembled device will be on the market in September if all goes as planned.

All surgeons must construct valved grafts (conduits) with tissue valves. And most of them use tissue valves. So it is not foreign to them at all.

We can work with any patient to find a surgeon who will use the On-X valve with or without the graft. This is successful at least 90% of the time. So please ask the patient to contact us if they want/need our help.

Best regards,

Catheran Burnett RN BSN
Manager, Education and Promotion
On-X Life Technologies, Inc.
 
What's successful at least 90% of the time? That doesn't sound like very good odds to me!
 
Thanks all for the excellent information. I did have bicuspid valve, but had it replaced at age 17. Apparently I did have some stenosis at that time. The doctor enlarged the artery somewhat. Today, 20 years later my valve still seems to working well but I'm measuring at 5.5 cm in my ascending aorta.

I am not completely opposed to a SJ valve, but I just want to make the best decision possible. I have had good luck with my Medtronic too, but a lower dose of coumadin would be nice. I will attempt to talk to my Doctor tomorrow when I go in for my preadmission. I don't necessarily feel strongly enough about it to call it off and search for another Doc. The one I have seems like a good guy (Oh and it's not the same Doc I had 20 years ago).

David - I'm not really familiar with the Freestyle Porcine valve. I am only 37 though so I'd be opposed to a valve that would not last as long as I do. I assume that is the case with the Freesytle?

Thanks again for the input.

Joe
 
Joecb:
You hadn't mentioned your age, I made my suggestion anyway just in case you were older. Anyway good luck on your surgery. It's not really as bad as you might think. Even at my advanced age of 69, I'm pretty well back to normal after only 6 months!

David L
 
David L said:
Joecb:
You hadn't mentioned your age, I made my suggestion anyway just in case you were older. Anyway good luck on your surgery. It's not really as bad as you might think. Even at my advanced age of 69, I'm pretty well back to normal after only 6 months!

David L
Click to expand...
Many people fit the constantly changing profiles for tissue valves. The decision to use tissue has many other factors besides age to be considered. Soon enough, it looks like age will be a bit-player in the criteria instead of the one that always seems to break into valve selection discussions at this time.

Joe, you can find the Medtronic Freestyle info here.
 
Faye said:
Just wanted to pipe in and let you know that I had my ascedning aorta, root and aortic valve replaced. I have an On-X valve - It can be done!
Click to expand...

Same, I had mine done just the same way last summer.
Here's at least two people that are living proof that it can be done with success.

Rob
 
On-X

On-X

Like you, On-X was my first preference, but my surgeon recommended a St Jude because the factory installed conduit would reduce my time on the pump. I'm not really sure how much time the conduit saved me, several folks have reported that a surgeon can sew on a conduit in short time.

My surgeon later told me that one of the reasons for his recommendation was that he was unsure of what kind of tissue issues he was going to encounter in my 5.8 cm aneurysm. He was concerned that he might have had to shift techniques once he got into my chest. 3.5 hours on the pump was enough for me.

The prospects of long-term coumadin use didn't excite me too much either. I'm pretty active and tend to bounce off the ground fairly frequently. It would probably help if I learned to stay upright on my mountain bike and skis. Other than bumps and bruises, I've had no issues with coumadin.

Opinions may vary, but I think it helps to have complete confidence in your surgeon. If you really want an On-X, find a surgeon you have confidence in to implant one. I doubt there's a shortage of really good surgeons looking for work. Good luck!

-Philip
 
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