[HSF] Valve Dysfunction - failure of Closure

[Nasser F. Abou'Seada]

I totally agree .... 
sometimes the decision is not the surgeon's to make .... !!!

NFA

> -----Original Message-----
> From: openheart-l-bounces at lists.hsforum.com [mailto:openheart-l-
> bounces at lists.hsforum.com] On Behalf Of jbflegejr at aol.com
> Sent: Wednesday, December 13, 2006 7:31 AM
> To: OpenHeart-L at lists.hsforum.com
> Subject: Re: [HSF] Valve Dysfunction - failure of Closure
> 
> When one has a faulty prosthetic valve that leads to patient harm, it
> should not be sent back to the manufacturer for if legal claims arise
> the valve will be needed for evidence and if it is defective, the maker
> is not likely to be able to find it and produce it for the litigation.
> You or your hospital should keep the valve in a vault and allow the
> maker's engineers to inspect it but not take it away. John Flege
> 
> -----Original Message-----
> From: donross at bigpond.com
> To: OpenHeart-L at lists.hsforum.com
> Sent: Tue, 12 Dec 2006 10:03 PM
> Subject: Re: [HSF] Valve Dysfunction - failure of Closure
> 
>    Nasser,
>   This is a very serious event and as far as I gather there is no proof
> that the valve was jammed shut although the clinical presentation
> strongly suggests this.
>   When you eventually got to the valve you said one leaflet was open and
> the other was not jammed.
>   Is that correct?
>   It would seem to be impossible for a suture or strand of tissue to jam
> both leaflets and it should have been obvious if that was the cause.
>   Another strange aspect of this case is the relatively late
> presentation.
>   One would expect an operative mechanical problem like distortion of
> the ring to present early.
>   Why would the valve jam while the heart was contracting and un-jam
> when the heart was virtually dead?
> 
>   I don't understand your reluctance to tell us the valve type. " Sacred
> brand" St Jude I expect but which type?
> 
>   The reason I am so concerned is that I have been involved in three
> deaths from the Shiley valve strut failure fiasco and I had a difficult
> time promulgating the danger involved in the use of this valve
> including in having a letter to the Lancet rejected; probably industry
> related.
> 
>   The valve company is likely to give you false information about other
> similar incidents if they have occurred or blame you for bad surgical
> technique
>  if my experience is anything to go on.
> 
>   Hal, can you shed more light on the problem you had with St. Jude
> valves jamming?
> 
>   Death from bad valve are inexcusable but also preventable. We all have
> a duty to be very suspicious of possible valve problems and to
> disseminate such information widely.
> 
>  Don
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