Mechanical vs Tissue - need help deciding

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pellicle

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Thanks Pellicle. This in- vivo study is from December 2018 (5 months ago) on trileaflet mechanical valves.
yes, I'm sorry I didn't find anything more recent. I recall that Dr Didier Loulmet was working on a trileaflet mechanical and that there was also a plastic one (touted as low priced) being evaluated too ... sorry to be unclear. Hopefully Warrick will chip in his 2c worth too ;-)
 

pellicle

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Thanks Pellicle. This in- vivo study is from December 2018 (5 months ago) on trileaflet mechanical valves.
I thought I'd share this little vignette

https://americanhistory.si.edu/collections/search/object/nmah_1726264

This trileaflet valve which looks similar to a natural human heart valve was developed by Charles Hufnagel, MD. It is coated in hepacone, silicone rubber impregnated with heparin, and is a size 5 with a diameter of 33mm. Hufnagel believed the trileaflet design would prove to be superior to the ball and cage heart valve because it provided better dynamics. The base of the valve was designed to fit the shape of the aorta when implanted. The leaflets or cusps were made of polypropylene and coated with silicone rubber at high pressure. A 1975 study of patients who had received this prostheses determined that the Hufnagel trileaflet valve was not durable enough to withstand constant blood flow. In a majority of cases, patients died due to prosthetic degeneration or thrombosis.​

so glad we test stuff better now...
 

Warrick

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I know I read that the last lot of animal trials (sheep for 3 months) for the Furtiva valve had gone well but I remember there was further testing that had not- I think it was further lab testing on flows with blood related media that had shown thrombosis was occuring in some parts that had not shown up previously, they shut down the website last year after that but I see its back up so progress must have been made

I recall reading Didye was tied up with the Foldax valve also but I have been unable to find where I read that so I may have my wires crossed..unsure.
 

Warrick

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So that other post by zelic is for a 3 leaflet mechanical but it isn’t the Furtiva valve from what I read.
The lastest from back in Feb from Furtiva is here in the press release that they have the capital to start human trials, the rest is in french which I haven’t read since school...

Looks promising but then theres a few new valves that do lately, I’d guess 5-10 yrs before something gets to mainstream maybe.
 

MethodAir

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As stated in another thread, 1.5 mg warfarin daily keeps my INR at 2.5. The ticking is always there, but only noticeable if you listen for it. That's not always a bad thing, you can test your heart rate, see if your heart rhythm is regular etc.
 

Nusb22

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I had an ON-x valve installed, a year ago (okay minus three weeks) had no issues with a ticking, and no issues with warfarin. My surgeon mentioned they've made improvements over the years.
 

MethodAir

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not sure if I've seen this before (or simply forgotten it) but WoW ... man that's fascinating. I wonder if you've had problems with clinics being freaked by that.

Thanks for reposting this
Regular self-testing keeps me out of the clinics. (y)
 

W. Carter

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I'm going on 5 years with Carbomedics Carboseal. Replacing ascending aortic and valve. Hardly ever notice any ticking anymore and test every 6 weeks for INR at VA Hospital unless it is off. If it is off they will schedule me every 2 weeks until back to normal. I have an ultrasound every two years. I am happy with it and no replacing.
 

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Art O Ceitinn

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I have a St Jude and had a few major bleeds. When I had hip replacement I bleed internally for 5 or 6 days and received multiple blood transfusion and cried tears of joy when I left the hospital after14 days. The pain from the bleed was by far worse than my heart surgery.
I can never hear the silence TIC TIC TIC
But my St jude is 12 years old and still keeping me alive.
It is a tough choice we all have to make.
 

Duffey

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I have a St Jude and had a few major bleeds. When I had hip replacement I bleed internally for 5 or 6 days and received multiple blood transfusion and cried tears of joy when I left the hospital after14 days. The pain from the bleed was by far worse than my heart surgery.
I can never hear the silence TIC TIC TIC
But my St jude is 12 years old and still keeping me alive.
It is a tough choice we all have to make.
Sorry to read of your experience. As you mention, valve choice is a difficult decision and none of us know what other health issues we may encounter in the years ahead. That’s why I suggest that new valve recipients give it some time before recommending one or another. Circumstances change, and what seemed like a logical choice one day can turn into a “why in the world did I choose this,” the next whether it is mechanical or tissue.
 

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