[HSF] Indigenous ring model X.1

[Ben Bidstrup]

>Prasanna,
>   Though it would seem inviting to have this handmade ring to be the  answer
>in bringing repair to the masses, I would caution readers in more  affluent
>situations to be very cautious, especially if there is the possibility  of
>litigation.  Many years ago, Cooley famously made flexible rings out 
>of  sectioned
>Dacron aortic grafts.  However, I don't believe too many surgeons  in America
>would be so bold. 
>   I still have significant concerns as to the completeness of followup  of
>these implanted prostheses.  Again, if it works well, more power to  you.  As
>for me, I'm not willing to take the risk of an adverse equipment  failure
>potentially robbing me of my retirement.
>
>Hal
>

Hal and Prasanna,
Each country has different pressures and rules. This has also changed 
over time. (All this is stating the bl...ding obvious, I know). With 
regulatory control as exists in many countries USA and Europe which 
as we have discussed at length are quite different, the ability to do 
some things of an 'experimental' nature is no longer possible. 
However, in the case of Prasanna, his decision making process about 
these aids to his surgical practice is determined by other factors. 
So the PM wire annuloplasty would not be acceptable to Hal's system. 
OK if it worked but get a failure, and his friends from the bottom of 
the ocean floor will be ruining his retirement plan.
We all aspire to high standards for our patients and doing harm 
intentionally is not an issue. Necessity is the mother of invention, 
and some have to use what is readily available and of course, 
affordable.

I look at operations I saw being done 25 years ago. To do some of 
them now would be considered unethical, but many of the procedures we 
do as part of our normal armamentarium had to be started somewhere, 
and the limits determined.

Many drugs we use routinely would now never get regulatory approval. 
Blood for example.



-- 
Ben Bidstrup FRACS FRCSEd FEBCTS
Consultant Cardiothoracic Surgeon