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On-X mechanical valve

  • 1.  On-X mechanical valve

    Posted 04-14-2023 13:06

    Hello All,
    I'm scheduled for open-heart surgery next week, April 20 to re-do an existing 12 year old  bovine tissue  aortic valve. (stenosis/end of its term) The surgeon will also repair my ascending aortic aneurysm during surgery. Both my cardiologist and my surgeon are highly recommending a mechanical valve because of its longevity. Potentially never needing re-surgery again. I'm resisting that recommendation because I fear the noise will prevent me from sleeping. I'm quirky in that regard. There is also the issue of taking and monitoring lifelong blood thinners. These are Quality of life concerns for me.
    My thought is to have TAVR when the next tissue valve expires. Most likely 2 more tissue replacements in my lifetime. I'm 67 years old, healthy and active otherwise. 

    Anyone out there with the On-X mechanical valve? Does the constant ticking bother you? Is the monitoring of your Coumadin cumbersome? Do you regret your choice?

    Thank you ahead of time for any input!
    Debi :) 



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    Debi Ries
    San Diego, Ca
    AVR / Open Surgery 2011/ TAAA 4.2 cm / Afib
    ------------------------------


  • 2.  RE: On-X mechanical valve

    Posted 04-15-2023 03:13

    Hi Debi,  I just wanted to say I am thinking of you as you approach surgery and am wishing you well.  I don't have any wisdom to share, as my experience is with heart by-pass.  Best wishes and stay strong. Pete



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    Peter Olson
    Sartell MN
    (763) 238-1830
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  • 3.  RE: On-X mechanical valve

    Posted 04-15-2023 14:11
    Thank you, Peter! I'm pretty nervous this second time around ... especially with the aneurysm repair in the plan. 

    Debi Ries
    c: (916) 548-3638 







  • 4.  RE: On-X mechanical valve

    Posted 04-17-2023 08:15

    Hello, Debi,
    I have had three OHS to replace my mitral valve. The last one also involved replacing my aortic valve. I had endocarditis three times, hence the replacements. The last time, my surgeon, though he didn't want to, used a mechanical valve for my mitral. I take Coumadin because it is the only thinner approved for mechanical valve. I monitor it at home and my cardiologist adjusts as needed. It is an adjustment to my daily life.
    I, however, don't hear ticking unless it is very quiet and I am very still. Even then it doesn't bother me at all.
    I wish you well and hope this helps a little.
    Best wishes…

    David Dolge



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    David Dolge
    Greenville SC
    (864) 918-8594
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  • 5.  RE: On-X mechanical valve

    Posted 04-17-2023 11:02

    Thank you, David! I'm sorry to hear you've had endocarditis so often, making several surgeries necessary. I wish you good health going forward! 

    It's very interesting that your surgeon did not want to use the mechanical valve. Both my cardiologist and surgeon want me to have the mechanical so that I theoretically won't need to have surgery again in my lifetime. 



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    Debi Ries
    San Diego, Ca
    AVR / Open Surgery 2011/ TAAA 4.2 cm / Afib
    ------------------------------



  • 6.  RE: On-X mechanical valve

    Posted 04-18-2023 09:43

    Debi,

    I have to admit, David is right and I was wrong about using the newer blood thinners as an alternative to Coumadin for mechanical values.  There was a years long study using Eliquis and similar class blood thinners but they recently discontinued the experiment when they determined that there existed a higher stroke and embolism risk than with warfarin/coumadin.  The medical establishment really wants to move on from coumadin and there will be continued research into using the next generation of blood thinners as an effective alternative.

    Ira



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    Ira Reid
    Hoboken NJ
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  • 7.  RE: On-X mechanical valve

    Posted 04-18-2023 12:05

    Hi Ira,
    Yes, it's something I have to take into consideration… I've been talking to one of the nurses at the anticoagulation clinic for my medical group so that I have enough information for an informed decision about a mechanical aortic valve. This is a tough choice for me! 



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    Debi Ries
    San Diego, Ca
    AVR / Open Surgery 2011/ TAAA 4.2 cm / Afib
    ------------------------------



  • 8.  RE: On-X mechanical valve

    Posted 04-15-2023 07:09

    Debi,

    I have no experience with valve issues, but I do have experience with blood thinners, which I took for a fee months after my bypass surgery 5 years ago.

    Why do you assume that you will need to take coumadin and constantly monitor your blood levels?  There are so many superior, more effective and safer blood thinners on the market.  I got off coumadin 5 days after I got out of the hospital and switched to Eliquis, which is safer and doesn't require any monitoring.  

    Now, this is not to say that the question of blood thinner for life vs no blood thinner isn't a valid question.  It is.  All blood thinners carry bleeding risks.  The baby aspirins that I have to take daily for the rest of my life also carry bleeding risks as do the nsaids I periodically take when the navicular bone syndrome in my foot flares up.  Still, you do have a blood thinner vs no blood thinner choice, but the inconvenience of weekly or more frequent blood level monitoring should not be an assumption you make in your decisionmaking process.

    Good luck next week and let us know what you wind up choosing.

    Ira



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    Ira Reid
    Hoboken NJ
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  • 9.  RE: On-X mechanical valve

    Posted 04-15-2023 14:17
    Hi Ira,
    You are correct,  I don't know which type of blood thinner. I was using Coumadin as a generic term. (silly me) I have used low-dose aspirin for the past 12 years with my aortic tissue valve. I'm very new to the ins-and-outs of the testing regimen for blood thinners. I guess I need to investigate further but not much time left!
    Thank you for your input! 

    Debi Ries
    c: (916) 548-3638 







  • 10.  RE: On-X mechanical valve

    Posted 04-16-2023 11:02

    Debi,

    There have been a lot of advances in blood thinners since the days that people had to use coumadin, what I like to call the Stone Age version of blood thinners.  Speak to your cardiologist about the newer alternatives.  

    And good luck on Thursday!

    Ira



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    Ira Reid
    Hoboken NJ
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  • 11.  RE: On-X mechanical valve

    Posted 04-16-2023 11:53

    Thank you, Ira!



    ------------------------------
    Debi Ries
    San Diego, Ca
    AVR / Open Surgery 2011/ TAAA 4.2 cm / Afib
    ------------------------------



  • 12.  RE: On-X mechanical valve

    Posted 04-15-2023 07:19
    Regarding Coumidin, I did the routine checks for over two years and got tired of doing that and switched to Pradaxa which I found to be the least expensive alternative. So if you can afford it, about 100 dollars a month with out a prescription plan then I would recommend asking your doctor to prescribe it for you instead of Coumidin.






  • 13.  RE: On-X mechanical valve

    Posted 04-15-2023 14:25


    Thank you, Clara!



    ------------------------------
    Debi Ries
    San Diego, Ca
    AVR / Open Surgery 2011/ TAAA 4.2 cm / Afib
    ------------------------------



  • 14.  RE: On-X mechanical valve

    Posted 04-15-2023 14:56

    Clara,
    I forgot to ask… Do you hear your mechanical valve and does it bother you at night when it's quiet and you're trying to sleep?



    ------------------------------
    Debi Ries
    San Diego, Ca
    AVR / Open Surgery 2011/ TAAA 4.2 cm / Afib
    ------------------------------



  • 15.  RE: On-X mechanical valve

    Posted 04-17-2023 01:41

    Debi,
    I know two people who have mechanical aorta valves and are on coumadin.  Neither have expressed any concerns relating to clicking or to coumadin.  
    Ed



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    Ed M
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  • 16.  RE: On-X mechanical valve

    Posted 04-17-2023 01:58

    Thank you, Ed!



    ------------------------------
    Debi Ries
    San Diego, Ca
    AVR / Open Surgery 2011/ TAAA 4.2 cm / Afib
    ------------------------------



  • 17.  RE: On-X mechanical valve

    Posted 04-23-2023 11:48
    Kumadin is an annoying blood thinner because of Monitoring and Nutrition issues BUT the best part is that it is quickly reversible when necessary ( antidote is available in ambulances)

    Marilyn B. Rosenhouse
    Mobile: (214)850-0655




  • 18.  RE: On-X mechanical valve

    Posted 04-23-2023 12:02

    Thank you, Marilyn!



    ------------------------------
    Debi Ries
    San Diego, Ca
    AVR / Open Surgery 2011/ TAAA 4.2 cm / Afib
    ------------------------------



  • 19.  RE: On-X mechanical valve

    Posted 04-18-2023 08:42

    Hello! I had OHS for bicuspid valve and thoracic aortic aneurysm 6 weeks ago. Valve was replaced with the On-x valve. I can tell you I do not hear a ticking but do hear a deep "drum" sound for lack of better term. I have not been bothered by it at all and it has not given me any issues when it comes to sleep. If anything I get nervous if I DON'T hear it lol. As for the warfarin, I was told at this stage the FDA has not approved any other blood thinner for mechanical valves besides warfarin so you may want to discuss that with your surgeon to be sure. I am on warfarin and it is a  lifestyle but it is doable. I know they are constantly testing other blood thinners and trying to get them approved for mechanical valves but none have been yet besides warfarin. Good luck with your surgery!!!



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    Erin Feaker
    IA
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  • 20.  RE: On-X mechanical valve

    Posted 04-18-2023 10:50

    Thank you, Erin!!



    ------------------------------
    Debi Ries
    San Diego, Ca
    AVR / Open Surgery 2011/ TAAA 4.2 cm / Afib
    ------------------------------



  • 21.  RE: On-X mechanical valve
    Best Answer

    Posted 05-19-2023 05:56

    I have the On-X mechanical valve. I have never had any issues with the noise, as it is not loud enough to cause significant disruptions. The monitoring of the Coumadin is manageable; my cardiologist helps me keep track and I make sure to take my blood tests regularly. Overall, I do not regret my choice. Having the mechanical valve ensures that I will not have to go through open-heart surgery again, which was a major factor for me when making my decision.

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    ------------------------------
    carlo pinini
    Engineer
    TDLS
    Miami FL
    ------------------------------



  • 22.  RE: On-X mechanical valve

    Posted 05-19-2023 11:01

    Thank you, Carlo. I'm now 3 weeks out from surgery (4/27/23.) I have the On-X valve and using Warfarin/Coumidin. The sound from the mechanical valve is more like a vibration in my neck/ear, rather than outwardly audible. We are still working on the proper dosage of Warfarin these early days. I too am happy with my choice. The aneurysm was also repaired … so I should not have to go through open surgery again in my lifetime! 



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    Debi Ries
    San Diego, Ca
    AVR / Open Surgery 2011/ TAAA 4.2 cm / Afib
    ------------------------------



  • 23.  RE: On-X mechanical valve

    Posted 05-19-2023 11:51

    Sounds like you had a good outcome Debi!  Did you have a full sternotomy?  If so, are you having any pain from the incision?  
    Hope you continue to do well!



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    Ed M
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  • 24.  RE: On-X mechanical valve

    Posted 05-19-2023 12:24

    Hi Ed, I had a full sternotomy and spent 7 days in the hospital. No pain 3 weeks out from surgery! The pain meds got ahead of the pain when I used them the first 2 weeks. I could not receive any pain meds or anti-nausea meds in the ICU right after surgery because of some issues with blood gases. It was a horrible night but I'm doing great now! Just moving slow as I mend. 



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    Debi Ries
    San Diego, Ca
    AVR / Open Surgery 2011/ TAAA 4.2 cm / Afib
    ------------------------------



  • 25.  RE: On-X mechanical valve

    Posted 05-19-2023 14:01

    Glad to hear that things have resolved and you're doing well now!  Welcome back!



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    Ed M
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  • 26.  RE: On-X mechanical valve

    Posted 05-19-2023 15:25

    Thank you, Ed!



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    Debi Ries
    San Diego, Ca
    AVR / Open Surgery 2011/ TAAA 4.2 cm / Afib
    ------------------------------