[HSF] Possible infected Freestyle

[hgrmd at aol.com]

John,
  Obviously, I agree with your choice.  BTW, since this was a recent hot topic, I have absolutely no vested interest in what valve or ring anyone uses.  I do firmly believe that the Magna is currently the best aortic bioprosthesis available for the average case.  I know of some other valves in testing that may eventually change my opinion.
 
Hal 
 
-----Original Message-----
From: streitman at yahoo.com
To: OpenHeart-L at lists.hsforum.com
Sent: Tue, 1 May 2007 4:49 PM
Subject: Re: [HSF] Possible infected Freestyle


Hal,

Unfortunately at the time the only valve on the shelf
was Medtronic.  I am new here but have finally gotten
Edwards valves on the shelf.  I have spent the past
several months trying to sort out the propoganda
regarding tissue aortic valve data.  I have found
several things interesting.  Specifically comparing
the Mosaic Ultra to the Perimount Magna, I have found
that the sizers for these valves are not the same.  If
you look at the barrel end of both sets, the Magna is
true to size (ie 25 is 25) and the Ultra barrel end is
smaller than stated ( a 25 is really 23mm in
diameter).  What this does in my opinion is make you
think you are getting a bigger Medtronic valve in the
same sized hole.  I think the EOA size for size b/t
the two is better in the Edwards valve.  I guess what
I am getting at is I believe that the Magna is a
better choice from an EOA/gradient standpoint and now
have that available.

John
--- Hgrmd at aol.com wrote:

> John,
>   Welcome to our club.  I hope one of the principles
> you learn  from this 
> case is that less is often more.  I don't know of
> many 80 yo  patients who would 
> truly benefit from the hassle of a 25 mm stented 
> prosthesis.  If you had 
> placed a 23 mm C-E Magna, you would have gotten the 
> same effective orifice area, 
> and presumably not had this terrible  complication. 
> I'm not sure what Tea was 
> implying about the use of pledgets  on the
> aortotomy, but I recommend you use 
> them liberally.  Losing control  of an aortotomy is
> a very lonely feeling.
> Hal
> 
> 
> 
> ************************************** See what's
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John E Streitman, M.D.
Cardiovascular Surgeon
Pinehurst Surgical
streitman at yahoo.com

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