What Are The Benefits Of An On-x Aortic Valve Replacement?

Posted on Sat, 8 Feb 2014

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Sat, 8 Feb 2014 Answered on

Wed, 12 Mar 2014 Last reviewed on

Question : What are the benefits of an On-x aortic valve replacement versus the traditional St. XXXXXXX aortic valve? Is one more quiet than the other? How about the need for blood thinners?

Answered by Dr. Benard Shehu (5 hours later)

Brief Answer: On-x valve are quieter & need less anticoahulants. Detailed Answer: Hi XXXX, i read your query and understood your concern. The on-x valve has the following benefits (compare to st. XXXXXXX prosthetic valve): 1- It doesn't form hemodynamic turbulence as other prosthetic valve (st. Jude) do. 2- As a result no hemolytic anemia (which is a mayor complication of prosthetic valves). 3- Although some rumor is heard it's quieter than st. XXXXXXX valve. 4- The PROACT study show that patient with an on-x valve can be maintain safety on anticoagulation therapy (with blood thinners) below currently recommended guidelines (i.e. to maintain the INR ratio between 2.0 - 3.0). Patient with on-x valve can maintain safely within an INR ratio 1.5 - 2.0. So the patient with on-x valve should take the same anticoagulants with a low dose. 5. As a result patients with ON-x valve will have less hemorrhagic complication due to anticoagulation therapy (blood thinners). Hope it was of help! Dr. Bneard

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Benard Shehu (1 hour later)

Thanks. What are the relative disadvantages of the On-x valve versus the St, Jude?

Answered by Dr. Benard Shehu (6 hours later)

Brief Answer: Disadvantages of On-x vs St-Jude explained below.. Detailed Answer: Hi again, Thank you for following up. The relative disadvantages of On-x valve insertion is that this is a new practice and few doctors can achieve to do it While, St XXXXXXX is an old technique, which can be easily handled by the majority of doctors without difficulties. Furthermore, it has been implemented since long time with standardized operational and follow-up strategies as compared to On-X, which still needs further conclusive studies. However, although such disadvantages, it all depends on the personal choice of the surgeon which technique to choose in order to achieve a specific (personal) goal. Hope it answered to your query! Dr.Benard

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Benard Shehu (14 days later)

I am now thinking of getting an organic valve just to avoid the need for blood thinners. In addition, I have been told that should be able to have a simple procedure to replace the valve should it need repair after 8-10 years, that would not require full open heart surgery. I am also concerned about the clicking sound of the mechanical valve. There is also a chance that I may have to have some of my aortic root replace, but that decision will be made at the time of the surgery based on the condition of the root. Other than the enlarged heart from the murmur, I am in excellent health. Low cholesterol, low BP, excellent arteries (per the CAT Scan), avid runner, etc. What would you recommend for my replacement valve. I am 66 years.

Answered by Dr. Benard Shehu (22 hours later)

Brief Answer: Following answers to your queries.... Detailed Answer: Hi again, I have read your queries and understood your concerns. It is true that the biological valves are not associated with clicking sound as compared with the mechanical valve. Furthermore, there is no need to use anticoagulants while biological valves are placed. The only problem is related to the replacement within 10 years and their high cost. With regards to the aortic root problems, I'd suggest to run angiography to determine if there are coronary blockage and if cabg and aortic root replacement is necessary. Hope it answered to your queries! Dr.Benard

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar