[HSF] Trip to Croatia

[Ben Bidstrup]

One of the things that we need to look at is the evidence that Starr 
Edwards valves are more thrombogenic. This came up in discussion 
recently and I posted some references on long term followup of those 
valves.
Now we don't know whether the patient in a country like Croatia would 
have to buy another valve? Prasanna may be able to elucidate. But 
applying US standards to Europe may not be appropriate as the rules 
are quite different.
I believe having put a lot of these valves in over the years that 
they are a good valve. Show me the 40 year data on St Jude and 
Carbomedics and ATS (a bit like our arguments re DES)
Have a Good Easter break.



>Prasanna,
>   Congratulations on your successful trip to Croatia.  Bojan and  his men put
>you through your paces!  I echo Ani's comments.  Unless  the reason was
>compelling financially, I definitely would have gotten rid of  that archaic
>Starr-Edwards in a multi redo patient.  That was probably her  last 
>opportunity to be
>safely redone.
>   Also, unless the posterior leaflet couldn't be reconstructed, why  would
>you use a Mitrofast with bileaflet prolapse?  The margin of error  with the
>anterior leaflet is much less than the posterior.  If you could  fix 
>the anterior,
>surely the posterior could have been repaired as well.   As far as I know,
>there exists no long term followup of this device.  We  have no assurance that
>it will function in the same way as a well-repaired  myxomatous valve. 
>   Criticisms aside, I am envious that you got to make such a  trip.  My hope
>is to do something similar in the future, because I've  always learned
>something useful when I've done as such.
>
>Hal
>
>
>
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-- 
Ben Bidstrup FRACS FRCSEd FEBCTS
Consultant Cardiothoracic Surgeon