[HSF] Associated Coagulation Mishaps

[psimha]

We did not have real problems as far as anticoagulation was concerned 
(compared to other  valves) but these patients would have a progressive 
rise in
gradients and when it would become significant and we re operated there 
would be extensive florid pannus extending all over and not like a "ring 
pannus " that we see often with other valves.
Prasanna

Nasser F. Abou'Seada wrote:
> Dear Prasanna 
> What was your observed incidence of coagulation mishaps with this valve ????
> .... I don't have the figures myself ready at hand .... nor have I conducted
> an RCT .... yet ...just a "run" of costly "series" that convinced me not to
> jeopardize more lives .... !!!!
>
> NFA
>
>   
>> From: prasannasimha
>> Omniscience was a terrible valve wrt Pannus . It seems to be a unique
>> reaction to its sewing rim and I would not do Pannus excision for these
>> valves.
>> Prasanna
>>
>> Michael Firstenberg wrote:
>>     
>>> Common finding with Omni valves?  I was told this was more common with
>>> the
>>> St Judes.
>>>
>>> -michael
>>>
>>>
>>> On 10/16/06, Nasser F. Abou'Seada <nfaabouseada at gmail.com> wrote:
>>>       
>>>> Dear Prasanna
>>>> another proof that the presence of the valve as a foreign body per se
>>>> elicits pannus formation as a reaction ..... in fact, as you have
>>>> mentioned
>>>> here .... I agree with you that the SUTURE TECHNIQUE and plan of
>>>>         
> tissues
>   
>>>> as
>>>> opposed to the implanted prosthesis... is more deciding for pannus
>>>> formation, than the mere presence of the prosthesis itself per se.
>>>>
>>>> I do concur with your observation about Omniscience / Omnicarbon valves
>>>> ....
>>>> I used to call them Ominous-sign valves ... !! ....
>>>> Incidentally another proof that the TYPE of the prosthesis is more
>>>> deciding
>>>> for/relating to pannus formation rather than the mere presence of the
>>>> prosthesis itself as a foreign body ...!!
>>>>
>>>> NFA
>>>>
>>>>         
>>>>> From: prasannasimha
>>>>> Great James,
>>>>> Incidentally did you use non-everting or everting sutures this time ?
>>>>> This "underside" pannus seems to be a common mode of failure of
>>>>> prosthetic valves. As I said using a noneverting suture technique
>>>>>           
>>>> in the
>>>>         
>>>>> aortic position has sharply reduced its incidence in my practice.
>>>>> I did find a higher incidence when we were using Omniscience and
>>>>> Omnicarbon valves
>>>>> Prasanna
>>>>>           
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