Hey Chuck & Amy, one more thought to look into. I too, fluctuated back & forth between SJM & On-X. I was settled on the SJM going into surgery and left it up to my surgeon. He chose the On-X for my anatomy. When I asked him why, he stated that it is less likely to allow pannus formation which eventually can be very bad. That is why it is "bulky". It is designed with flared inlets to prevent the formation. Good luck with your decision!Hi Amy,
During my first consultation I expressed to my surgeon that I wanted a biological valve. By the time I had crossed into severe and was facing surgery, only 6 weeks after the first consult, I had done a lot more research and felt that a mechanical valve was right for me. I had messaged him ahead of time to inform him of my new preference and also that I was primarily interested in the St. Jude or Onyx valve, again based on research. I like that the St Jude has 30 year outcome data- showing great durability: https://www.jtcvs.org/article/S0022-5223(18)32341-9/pdf#:~:text=Thirty-year freedom from reoperation,and mitral valve replacement, respectively.
On the other hand, I liked the idea that the Onyx valve might allow a person to get by with a little lower INR, thus less coagulant, although the literature in support of this is controversial. When I arrived he presented me with two mechanical valves and asked me to choose which one I would want him to put in me, knowing nothing other than their physical appearance. One was about half as bulky as the other and I chose that one. He said, that is the St. Jude. He said he strongly prefers the St. Jude and was critical about the Onyx due to the size- it is literally about twice as bulky as the St. Jude. He also brought up the argument for the Onyx and said that he and most of his colleagues were totally unconvinced by the data suggesting that the Onyx can get by with a lower INR. I had been leaning towards the St. Jude, because they held up so well in the 30 year study and I have heard such good things about them from folks that had them put in decades ago. To be fair, I have heard good things about the Onyx too and I know that many are happy with their Onyx valves. I think that they are both probably good valves, just prefer the proven track record of the St. Jude. In my view, if something lasts as long as the St Jude, with great hemodynamics, why try to invent a new wheel? But, I would have gone with the mechanical valve that he preferred. It just so happened that he prefers the one that I was already partial to, so I was glad to hear his views. I can tell you, they are truly remarkable little devices. It was nice to be able to play with each of them and see how sturdy they were. After handling it a bit, I told him to make sure he rinses it off really well before he puts it in me, I'm sure that is not the one they will use, the display model- at least I hope not.
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