[HSF] de Vaga

[erdinç naseri]

Hal,
I agree with you about the superiority of a ring to Devega but ı also have 
to add that many cardiac surgeons in places other than USa and several 
developed countries work under economic and physical conditions which are 
quiet different than you. and this sometime s a suboptimal treatment the 
only one available.Let me give an overview of our OR to you for better 
understanding:
1.No TEE available all the time.
2.No autoransfusion device for aortic cases all the time.
3.Use mostly reused IABP catheter
4.Use  the cheapest oxygenator available so that if CPB>150 minutes then 
hemolysis is 100% there.
5.No epiaortic US
6.Rings can be purchased for only 5-10%  of the patients ( patient pays)
7.Bioprosthesis are not reimbursed totally by social security so that the 
patient must pay an additional amount.
8.No bioglue available.
9.No valved conduit is reimbursed so I have to tailor one from a conduit and 
a valve and this increases bleeding
I can extend this list to 100 .So sometimes a quick and suboptimal operation 
saves the day.
erdinc



>From: Hgrmd at aol.com
>Reply-To: OpenHeart-L at lists.hsforum.com
>To: OpenHeart-L at lists.hsforum.com
>Subject: Re: [HSF] de Vaga
>Date: Sat, 17 Mar 2007 09:37:24 EDT
>
>Don and Ahmed,
>   BTW, suppose you or your wife were having your severe TR fixed as a  
>part
>of some cardiac operation.  Would you, in all honesty, rather the  surgeon 
>use
>a piece of suture to fix it, or would you rather he splurge on a  tricuspid
>ring?
>
>Hal
>
>
>
>
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