Echocardiographic Signature of the On‐X Valve

Yezbick, Aaron B.; Ho, Jonathan K.; Crowley, Ryan; Sánchez, Elizabeth; Mahajan, Aman

doi:10.1111/j.1540-8175.2008.00770.x

Cited by 2 publications

(1 citation statement)

References 6 publications

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“…18 Knowledge of these jets is important to avoid erroneous diagnosis of a perivalvular leak (assessed by measuring jet width, jet area, the ratio of jet diameter/LVO diameter and jet area/LVO area). As reported by Chambers et al, 19 the effective orifice area (EOA) should be measured using the ratio of the LVO tract and transaortic velocity-time integrals in the continuity equations.…”

Section: A C C E P T E Dmentioning

confidence: 99%

On-X Valve

Chaudhary

Garg

Krishnamoorthy

et al. 2017

Cardiology in Review

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The On-X valve is a newer generation mechanical bileaflet valve. Its key features include the use of pure pyrolytic carbon (devoid of silicon), a length-to-diameter ratio similar to a native valve, an inlet flared orifice, a leaflet opening up to 90 degrees, a shorter leaflet closing angle, a 2-point leaflet contact, and an actuated pivot. These features have translated into increased strength, improved valve hemodynamics, reduced hemolysis, and thrombogenicity. The 2014 American Heart Association/American College of Cardiology guidelines for the management of patients with valvular heart disease recommend an international normalized ratio (INR) of 2.5 (range, 2-3) in patients with a mechanical valve at the aortic position. However, based on the results of the Prospective Randomized On-X Anticoagulation Clinical Trial (PROACT), the Food and Drug Administration approved this valve in April 2015 in the aortic position with a lower INR goal of 1.5-2.0. This reduction in INR goals led to a statistically significant reduction in the combined endpoint of clots, bleeding events, and stroke rates with 9/patient-years for the lower INR group compared with 12/patient-years in the standard INR group. This review compares the currently available literature on the On-X valve with that of other contemporary valves.

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Section: A C C E P T E Dmentioning

confidence: 99%