[HSF] Trip to Croatia

[Hgrmd at aol.com]

Bojan,
  Wish I could have been there to see Prasanna slaving away!.  I  totally 
agree with Ani that the continuous suture technique is a by product of  the Texas 
Heart cowboy mentality in which "the fastest gun in the  West" is considered 
the way to go.  I've watched Dave Adams and Carpentier  take 3 hours to do a 
complex, but high quality mitral repair.  With the  proper attention to 
myocardial preservation, I'd much rather have that mindset  used on me or my family.  
My approach is to go fast when I can, but to use  all the time needed to do a 
complete, thorough job.  That is why I've never  considered using the 
continuous suture technique for valve procedures.  One  slipped stitch, and the whole 
procedure is at risk, as amply illustrated by  Prasanna's case.  
  As for the legal implications of the case, I doubt that a suit  stemming 
from paravalvular leak attributed to the continuous suture  technique would get 
very far.  There would be plenty of literature and star  experts who would 
support the technique.  However, you and I both know that  it originates from 
"slick" surgeons.  Why else would you use it?   To save money?
Hal 



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