[HSF] Time to say adieu to a great valve?

Sun Feb 11 13:59:53 EST 2007

Dear Tushar 
Thank you for sharing your experience with us. No doubt I do agree with you
about the qualities of the SE valve. We have had patients of this valve for
25 years now with no complications. in some cases of small LV I have found
the valve cumbersome to insert, yet there was no hassle, as you have said,
about rotating the valve for best opening position, especially in these
particular small ventricles. 

Thank you again for sharing your thoughtful opinions with us. 

NFA

> -----Original Message-----
> From: openheart-l-bounces at lists.hsforum.com [mailto:openheart-l-
> bounces at lists.hsforum.com] On Behalf Of Tushar
> Sent: Saturday, February 10, 2007 1:37 PM
> To: OpenHeart-L at lists.hsforum.com
> Subject: Re: [HSF] Time to say adieu to a great valve?
> 
> NFA,
> I do not use Starr valve in aortic position. Most of its virtues I
narrated
> have been for its use in mitral position. Any disc valve including Chitra
is
> good in aortic position.
> 
> I agree it can be tight in some small ventricles. However, 2M valve most
> often goes in well even in small ventricles of calcific mitral stenosis.
1M
> is too small and I have not used at all.
> 
> Theofilo,
> I am sorry, I have no comparative data.
> 
> Rizzoli,
> Chitra valve is economical and is in use since more than 15 years. It is
> backed by sound publications.
> 
> Hal,
> I agree with most of your comments. When I say "service product" I do not
> mean free, I mean less profit. In any case, making an "archic" valve may
be
> neither attractive "service" nor business and hence time to say adieu.
> 
> Tushar
> 
> ----- Original Message -----
> From: "Nasser F. Abou'Seada" <nfaabouseada at gmail.com>
> To: <OpenHeart-L at lists.hsforum.com>
> Sent: Saturday, February 10, 2007 8:35 PM
> Subject: RE: [HSF] Time to say adieu to a great valve?
> 
> 
> > Ease of implantation in small hearts, ..... especially when the exposure
> is bad (redo, reredo cases)
> 
> Dear Tushar
> I do agree in with most of what have you said. SE valves proved to be the
> most durable valves in my experience. However I've found it a little
"tight"
> to insert SE valves in a small ventricle, and in small aorta as well. the
> last that I've experience with was the SE 2000.
> 
> NFA
> > -----Original Message-----
> > From: openheart-l-bounces at lists.hsforum.com [mailto:openheart-l-
> > bounces at lists.hsforum.com] On Behalf Of Tushar
> > Sent: Saturday, February 10, 2007 4:37 AM
> > To: OpenHeart-L at lists.hsforum.com
> > Subject: RE: [HSF] Time to say adieu to a great valve?
> >
> > Thrombosis of disc valves in mitral position in spite of regular
> > anticoagulation,  is not unusual. On the other hand, same is not true
for
> > ball valve. This has been discussed often in our conferences. Even
ardent
> > users of Chitra valves also agree to this.
> >
> > Ball valve goes on and on even when anticoagulation is not adequate as
is
> > often the case in our country. Stanley has reported a case of 30 year
> > survival in tricuspid position for Ebstein without any anticoagulation!
> Disc
> > valves are not forgiving. This is one reason why Starr valves are still
> > popular in our country in spite of its drawbacks.
> >
> > Ease of implantation in small hearts, freedom from botheration of
checking
> > the disc movements especially when the exposure is bad (redo, reredo
> cases)
> > are other virtues.
> >
> > Durability is never a problem and most of our patients do not seem to
mind
> > higher gradient and excess noise.
> >
> > I agree, making it may not be anymore profitable to the company. Hence,
I
> > expect them to make it as a "service product". Explore this while you
are
> in
> > Jaipur. You will find many Starr lovers there!
> >
> > Prasanna, I am not in Jaipur, but why not return from Jaipur via
> Ahmedabad?
> > I assure you easy access to the net and great hospitality!
> >
> > Tushar
> >
> >
> >
> > -----Original Message-----
> > From: openheart-l-bounces at lists.hsforum.com
> > [mailto:openheart-l-bounces at lists.hsforum.com] On Behalf Of Prasanna
Simha
> M
> > Sent: Saturday, February 10, 2007 1:59 PM
> > To: OpenHeart-L at lists.hsforum.com
> > Subject: Re: [HSF] Time to say adieu to a great valve?
> >
> > With the economical Chitra valve available , I cannot see the need now
to
> > implant a Starr Edwards at least in India. I do not think the Chitra
valve
> > is any better or worse than any other single tilting disk valve in the
> > market. With the decreased implantation rate I think Edwards must have
> > decided to pull it out.
> > Tushar, cannot ee you in the conference. I am finding it difficut to
> access
> > the internet in Jaipur.
> > Prasanna
> >
> > On 2/8/07, Tushar <tushar at icenet.net> wrote:
> > >
> > > I have not seen any official note from the supplier of valve. However,
> > > Edwards representatives meeting us regularly have given this news and
no
> > > new
> > > supply is available.
> > >
> > > Can they not continue making it as a "service product"? Can someone
from
> > > us
> > > who are using it today get this done?
> > >
> > > Tushar
> > >
> > > -----Original Message-----
> > > From: openheart-l-bounces at lists.hsforum.com
> > > [mailto:openheart-l-bounces at lists.hsforum.com] On Behalf Of A
> > > Sent: Wednesday, February 07, 2007 10:24 PM
> > > To: OpenHeart-L at lists.hsforum.com
> > > Subject: RE: [HSF] Time to say adieu to a great valve?
> > >
> > > I am missed the news did the company stop making it? Where did you
read
> > > this?. Thanks
> > >
> > > Ahmed
> > >
> > >
> > > -----Original Message-----
> > > From: openheart-l-bounces at lists.hsforum.com
> > > [mailto:openheart-l-bounces at lists.hsforum.com] On Behalf Of Tushar
> > > Sent: Tuesday, February 06, 2007 5:24 AM
> > > To: OpenHeart-L at lists.hsforum.com
> > > Subject: [HSF] Time to say adieu to a great valve?
> > >
> > > Starr-Edward valve is no longer available. In these days of better
> > > bioprosthetic valves and bileaflet disc valves, there will be very few
> > > surgeons across the world who will feel saddened by this news. Even
> than,
> > > worldwide nearly 3000 valves per year, largely mitrals, were being
used
> > > till
> > > yesterday. It was a popular valve among several Indian cardiac
surgeons
> > > and
> > > was often still used in premier institutes like Escorts Heart
Institute.
> > > Many will wish that it should still be available for some patients.
> Alas,
> > > profession has no control over industry or market forces.
> > >
> > > Let us salute the valve and bid a warm farewell to one which really
set
> > > the
> > > ball (pun intended!) rolling!!!
> > >
> > > Tushar
> > > _______________________________________________
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> >
> > --
> > Prasanna Simha M
> > _______________________________________________
> > OpenHeart-L mailing list
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