kinds of mechanical valves

[joy]

I am looking at having a double valve replacement, and am going with Mechanical, I am wondering what anyone thinks of the different brands and kinds of mechanical valves? I am having my Aortic and Mitral valves replaced. Thanks guys!

 

[Ross]

Heck you have all sorts of choices, St. Jude, On-X, those are the top two right now, then you have all the others, ATS, heck a few more that aren't coming to me at the moment.

 

[ALCapshaw2]

The Big Four in the USA are ATS, Carbomedics, On-X, and St. Jude in alphabetical order.

Member dtread has posted a list of their websites in the past, or you can Google those names.

See www.heartvalvechoice.com and www.onxvalves.com for On-X info and www.sjm.com for St. Jude info.
I don't remember the websites for ATS or Carbomedics.

I made a post listing performance characteristics of all 4 some time ago in a thread titled "St Jude" or "St Judes" but the Search Feature doesn't seem to be working this morning (at least not with my computer / operating system).

ALL 4 of the USA Big 4 were designed at least in part by Jack Bokros, Ph.D. who developed the pyrolytic carbon used in the leaflets for an applicaiton in the Nuclear Power Industry back in the 60's. He has been designing Heart Valves ever since, and formed On-X to produce his "Latest and Greatest" design. I tried to search for my posts outlining his background but again the Search Feature did NOT work (for me). Try a Search for keyword "Bokros" to find those posts.

'AL Capshaw'

=================

Here is my post from 2009 "St Jude" Thread listing the overall 'event rates' for the Major Mechanical Valve Manufacturers. We have members who have valves from all 4 manufacturers who are doing well while properly anticoagulated.

The manufacturers argue all argue about certain design features of their valves. Personally, I'm impressed with the advancements offered by the On-X valve which was designed to lower the already low 'event rates' of mechanical valves. To my (engineering / non-medical-professional) mind, the BIG difference comes at those times when it is necessary to go OFF anti-coagulation for invasive procedures.

QUOTE

A few years ago, On-X sent me an 'Information Package' which included a pair of tables entitled "Morbid Event Rates Comparison" for both the Aortic and Mitral positions with footnotes indicating the source of the data for each company which included PMA (something about Safety and Effectiveness) Summaries (ATS and CMI) and FDA submissions.

The combined rates in (% per pt-year) for Thromboembolism, Thrombosis, and Hemorrhage for the

Aortic Position were

On-X = 2.14 % per pt-year
SJM = 3.90 St. Jude Medical
CMI = 2.96 Carbomedics
ATS = 4.04 ATS
MH = 2.50 Medtronic Hall (I believe that is a single leaflet valve)

Mitral Position

On-X = 1.86 % per pt-year
SJM = 3.34
CMI = 4.44
ATS = 5.07
MH = 4.30

I left off the breakdowns by categories because I'm not about to sit here and re-type all that data. Note that other factors such as Hemolysis (blood cell damage) and Pannus Tissue Growth are not included in the above statistics.

The complete charts are available to ANYONE who asks for them. Just call or e-mail On-X and they will send you whatever information you request. Contact information is on their website www.onxvalves.com or 888-339-8000.

They have recently published another set of Bar Graphs which also include several tissue valves (which I find a little hard to interpret - too much information in too little space... give me the numbers in a spread sheet format please).

'AL Capshaw'

END QUOTE

 

[drivetopless]

I'm in the mechanical valve selection stage, too, Joy. From what I've read, they are all pretty good. My grandfather had a St. Jude for 30+ years and did quite well. I'm leaning toward the On-X. There's some very promising data and anecdotes on it as Al mentioned. I will be living with the new valve 40ish years, so I like the idea of possibly being able to reduce the daily warfarin dosage one day if the PROACT trial proves successful.

I was briefly considering tissue, but am glad to learn mechanical would be a better choice FOR ME since osteoporosis is prevalent in my family and calcium supplements may affect the longevity of a tissue valve.

http://www.onxlti.com/onxlti-hvm-clinical-updates.html

Good luck!

 

[dick0236]

I'm leaning toward the On-X. There's some very promising data and anecdotes on it as Al mentioned. I will be living with the new valve 40ish years, so I like the idea of possibly being able to reduce the daily warfarin dosage one day if the PROACT trial proves successful.
Good luck!

Very good insight...."living with the new valve 40ish years", although 43 years ago you could not have convinced me of that. I know little about the new valve choices, since I seldom think of a "reop", but I see a lot written on the On-x and St. Jude

I am now feeling lost:tongue2:. First, they took my valve out of production in 2007(I think), after about 50 years of successful use......now I find out that they have just taken my Chrysler PT Cruiser out of production(the last car has come off the production line in Mexico):frown2:....I'm hoping that at the rate I put miles on either, they will both last the duration:thumbup: My biggest concern is not valve service, but where will I go for repairs on the "cruiser".....and how long will parts be available:confused2:. We are already experiencing problems with parts for my wifes' car, a Saturn(also taken out of production):frown2:.

 

[dtread]

As Al mentioned I have posted the valve manufacturer info in the past. I just updated it and here it is again:

U.S. Heart Valve Manufacturers:

ATS – Mechanical & Biological Valves (equine). Headquarters: Minneapolis, MN www.atsmedical.com

Carbomedics (Sorin Group) - Mechanical and Biological Valves (bovine). Headquarters: Italy (U.S. Sales and Marketing – Arvada, CO) www.sorin-hv.com

CryoLife, Inc. – Allografts. Headquarters: Atlanta, GA www.cryolife.com

Edwards Lifesciences - Biological Valves (porcine and bovine). Headquarters: Irvine, CA www.edwards.com

Medtronic - Mechanical & Biological Valves (porcine). Headquarters: Minneapolis, MN www.medtronic.com

On-X Life Technologies, Inc. - Mechanical Valves. Headquarters: Austin, TX www.onxlti.com

St. Jude - Mechanical and Biological Valves (porcine and bovine), also Alllografts. Headquarters: Minneapolis, MN www.sjm.com

Note: Biological is simply another name for “Tissue”, and Biological Valves are either Bovine (cow), Porcine (pig), or Equine (horse). There are also valves called “Homografts” or “Allografts” that are from cadavers.
Note: Mechanical heart valves today are all the “Bileaflet” design except for the Medtronic mechanical valve, which is the “Tilting Disc” design. In the past there was also the “Ball and Cage” design, but do not believe that the ball and cage design is sold anywhere (it is definitely no longer sold in the U.S.)
Note: Some of the above also sell products for valve repair (versus valve replacement)

If there are any errors or omissions, etc. in the above please advise

You can see that there are not a lot of valve manufacturers so your research burden is not that great. First is usually the biological vs mechanical choice. That is largely a decision of whether you want reoperations on a periodic basis for the biologicals or take anticoagulant mediation with the mechanicals. Once you get past that decision point you can narrow your research to the products offered. I cannot comment on the biologicals but if you decide to go mechanical I'd recommend On-X as it has great technology combined with the Proact Clinical Trial for reduced anticoagulation; see: http://www.clinicaltrials.gov/ct2/show/NCT00291525

Good luck whatever you choose.

 

[Lily]

. . .I was briefly considering tissue, but am glad to learn mechanical would be a better choice FOR ME since osteoporosis is prevalent in my family and calcium supplements may affect the longevity of a tissue valve. . .

I'm not sure this calcium supplement/tissue valve longevity information is accurate.
Adding this link: http://www.valvereplacement.org/for...95-Calcium-Supplements-Calcification&p=448790

And also, have you looked into possible calcium/osteo issues related to ACT?

 

[Ross]

Your body is responsible for Calcium production and depositing. It's more of a CYA thing then anything else. Pretty much like Penile Gangrene and ACT.