I've crossed the line into severe and need to make a decision

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Unicusp

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Jan 30, 2021
Messages
170
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.
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!
 

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epstns

Premium User
VR.org Supporter
Joined
Dec 26, 2002
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5,192
Location
Chicago area
Chuck - when it comes to the means of final closure, it may make a difference if you make your preference known before your surgery. When I discussed things up front with my surgeon, he indicated that their OR usually used staples for external closure. I asked about the "super-glue" and he said that he would use that if possible.

I guess he heard me clearly. I have about a 4-inch scar that is nearly invisible, even when I am sun-tanned. He even ran it on a slight angle so that I can wear a sport shirt with the top button or two open and the scar doesn't show.

I do, however, have stainless steel wire tied through my sternum. I've had no problems with it - even going through airport security. The pacemaker, on the other hand, always sets them off.

It pays to make your desires known. The worst thing they can do is not do what you wanted, but whatever they do, it will work.
 

Chuck C

Well-known member
Joined
Dec 5, 2020
Messages
395
Chuck - when it comes to the means of final closure, it may make a difference if you make your preference known before your surgery. When I discussed things up front with my surgeon, he indicated that their OR usually used staples for external closure. I asked about the "super-glue" and he said that he would use that if possible.

I guess he heard me clearly. I have about a 4-inch scar that is nearly invisible, even when I am sun-tanned. He even ran it on a slight angle so that I can wear a sport shirt with the top button or two open and the scar doesn't show.

I do, however, have stainless steel wire tied through my sternum. I've had no problems with it - even going through airport security. The pacemaker, on the other hand, always sets them off.

It pays to make your desires known. The worst thing they can do is not do what you wanted, but whatever they do, it will work.
I appreciate the advice. I will ask about in when I am there for my cath a few days before surgery.

"I do, however, have stainless steel wire tied through my sternum. I've had no problems with it - even going through airport security. The pacemaker, on the other hand, always sets them off."

I had wondered about whether people set off alarms from the metal in their chest after surgery. I have a titanium plate in my head from a blow out fracture of my left orbital 2 years ago and so far I haven't set off any metal detectors.
 

Chuck C

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Joined
Dec 5, 2020
Messages
395
Update: Just finished my angiogram. It went great. No blockages. CT on Tuesday showed no aneurism as well. So, I'm looking at just replacement of aortic valve with no other procedures. Going with a St. Jude mechanical valve in 3 days. I feel very comfortable with the team at UCLA. I'm in good hands. Thanks so much to all for the encouragement and wisdom. I'll soon see you all on the other side.
 

Superman

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Joined
Oct 3, 2009
Messages
1,144
Location
Grand Rapids, MI, USA
See you on the other side, @Chuck C! Given your athletic background, I’m sure you’ll do great. Agree with Spring being good. Healing with winter coming on wasn’t good for outside walks. 😁. Got to walk the mall with the elderly when I was 18.
 

Meanjellybean

3 OHS, 1 mechanical on the way - ETA 2 - 4 months
Joined
Mar 7, 2021
Messages
57
Location
Australia, NSW
Update: Just finished my angiogram. It went great. No blockages. CT on Tuesday showed no aneurism as well. So, I'm looking at just replacement of aortic valve with no other procedures. Going with a St. Jude mechanical valve in 3 days. I feel very comfortable with the team at UCLA. I'm in good hands. Thanks so much to all for the encouragement and wisdom. I'll soon see you all on the other side.
Wishing you well with your surgery and recovery Chuck.
Not sure if your religious but im praying for you 👍
 

Chuck C

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Joined
Dec 5, 2020
Messages
395
See you on the other side, @Chuck C! Given your athletic background, I’m sure you’ll do great. Agree with Spring being good. Healing with winter coming on wasn’t good for outside walks. 😁. Got to walk the mall with the elderly when I was 18.
Thank you. I feel about as ready as I can be. Despite the fact that the discharge instructions for the angiogram said no exercise other than walking with no hills, apparently out of an abundance of caution that I might start bleeding from my catheter puncture wound :unsure:, I thought better of it and broke the rules and did some steep hills today, several HIIT stair sets along with some lunges. I am happy to report that I did not bleed to death :)
 
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