India Tissue valve replacement- Comparision

[Rakesh Sharma]

India (Pune) - My mother(age 70) has been suggested to get AORTIS valve replacement . Doctors suggested below tissue valve. INSPIRIS being costliest(4.75L INR ~ 7000USD) , Magna Ease(3.1LINR - 4000USD) and rest all 2L~2600 USD. Any one has gone through with this anylysis, other then cost is there any other factors to be considered? Please help sharing if any one has any experience in comparing these.

 

[Timmay]

If I were 70, I would choose the Resilia. Why? Theoretically it will last longer. Additionally, if it doesn't, then the main ring of the valve is designed to expand for TAVR. I just think it is all around a great choice these days for older people.

 

[tom in MO]

India (Pune) - My mother(age 70) has been suggested to get AORTIS valve replacement . Doctors suggested below tissue valve. INSPIRIS being costliest(4.75L INR ~ 7000USD) , Magna Ease(3.1LINR - 4000USD) and rest all 2L~2600 USD. Any one has gone through with this anylysis, other then cost is there any other factors to be considered? Please help sharing if any one has any experience in comparing these.

View attachment 888732

In the US, valve cost is something a patient doesn't have to consider. I have a St. Jude and my cardio and surgeon believe it is good proven device.

 

[Rakesh Sharma]

If I were 70, I would choose the Resilia. Why? Theoretically it will last longer. Additionally, if it doesn't, then the main ring of the valve is designed to expand for TAVR. I just think it is all around a great choice these days for older people.

Thanks Timmay for a very practical point. Just one thing at the moment Docotrs suggesting SAVR(open heart surgery) and saying use TAVR for later age(if needed). I hope your reply cover for open heart.

 

[pellicle]

Just one thing at the moment Docotrs suggesting SAVR(open heart surgery)

err ... just wondering how you'd expect that they'd get the resilia valve in there without SAVR?

If you meant "replacing the Resilia if TAVR is not available" this is indeed how valves have been replaced for the last 5 decades ... by open heart (SAVR).

Best Wishes

 

[Timmay]

It all depends on the patient. Truly.

If I was 70 … and *if* I believed that my body would handle open heart surgery, then I would go for SAVR. Why? They’d get a bigger valve in there and it would be placed correctly. They could also conduct any other repairs that were needed (bypass, aorta issues, calcium removal, etc). That ensures a high level of success.

However - if I was 70 and believed that my body would not handle SAVR surgery well, I would seek additional input because it gets trickier when trying to plan out the rest of life.

I think the Inspiris Resilia only comes in a version meant for SAVR. Double check that for me though.

 

[erricojj]

Not a comparison of the valves you are considering, but there's a very good explanation of the history the clinical development of the Inspiris Resilia valve here...

Inspiring Results | Edwards Lifesciences

www.edwards.com

The ongoing study, called the Resilience study, started in 2018 with 250 patients who received the valve under 65 years old.

"The objective of the RESILIENCE trial is to determine the time to valve failure due to valve deterioration requiring re-intervention, as well as to collect/investigate early potential predictors of valve durability (e.g. calcification and hemodynamic deterioration) in RESILIA tissue. The RESILIENCE trial is the first prospective study to associate both clinical and imaging definitions of SVD with long-term (11 years) bioprosthetic valve durability."

I believe there are no negative signals coming from this or any of the previous studies...i.e. "so far so good ". It will run to 11 years post op in these patients.

It may be the costliest, but if it provides longer life with less probability of a future SAVR, then it's a very attractive solution for people considering tissue valves.