[HSF] Ao Wraping

[DukeB60 at aol.com]

Ani,
    Point well taken.  If I ever published these  results a statistical 
analysis would obviously be required but thus far I am  only sharing the raw data 
in an ongoing series.  I have no idea how many I  did in each respective year 
since the first one ten years ago.  In fact,  perhaps the numbers are so raw 
they aren't worth even bringing up.  
    Unfortunately, analyzing the actual durability and  other characteristics 
of various valve substitutes is a difficult process and  there are a 
multitude of statistical means to report (and sell) the data.   I am always curious as 
to why different surgeons select their valve of choice as  clearly there are 
many differing opinions and preferences - some well founded  and some not so 
well founded.  
     You asked what people thought of the Ross so  I simply intended to 
relate that in my somewhat limited experience the initial  mortality of the Ross is 
no different than other aortic valve procedures in a  low risk population and 
there is a body of literature to suggest  that longer term results are at 
least potentially as good or better than  porcine or bovine pericardial 
replacements - hence I offer the option  but only after a very thorough discussion.  
Thus far few have presented a  problem - statistically relevant or not.  There 
are, additionally, some  probable hemodynamic advantages, especially in younger 
patients who are  physically very active, that are potentially appealing as 
well to make the Ross  a worthwhile alternative.   I am also well aware that 
this is all,  undoubtedly, a decidedly minority opinion.
    None of the valve replacement options we have to  select from are perfect 
so I leave it to the individual patient to select their  poison.  
Interestingly, the cardiologists here seem to like the Ross for  some reason and often it 
is they who have planted the seed for the Ross as an  option before I am even 
consulted for a surgical evaluation.
 
                                                                              
                                      Ed
 
Edward P.  Raines, M.D., J.D.
BryanLGH Cardiothoracic Surgery
BryanLGH Medical Center  East
1600 South 48th Str.
Lincoln, Nebraska 68506
Office:  402-481-8430
Cell: 402-730-9242
Fax:  402-481-8429



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