[HSF] (no subject)

[rwmfglycar at aol.com]

I don't kmnow whether Tyrone is still using the TSPV or not but the reality is that with aortic root enlargement as an easy and very safe option (despite Tyrone's previous condemnation of root enlargement) and with the improvement in stented aortic valves the hemodynamic indication is now moot. The other thing to remember is that the TSPV did not have an anticalcification RX.
To enlarge on my point about follow up: if all the valves being followed have gone beyond 7 years this is a more severe test than the usual manufacturer's information in which shall we say a "10 year followup" will include many valves that have been followed from 1 month to 3 or 4 years, none of which tell anything about long term durability. Which is more valuable 800 patient years derived from 400 cases each followed for 2 years or 800 patient years derived from 80 patients all followed for 10 years?
What did you take Vokmar to see? I took Francis Smit, Chief of Cardiac surgery in Bloemfontein, SAfrica, to Frost and Nixon 2 weeks ago.
Bob

-----Original Message-----
From: Hgrmd at aol.com
To: OpenHeart-L at lists.hsforum.com
Sent: Sun, 13 May 2007 7:07 pm
Subject: Re: [HSF] (no subject)



Bob, First of all, I don't profess to be an expert in interpreting valve  
urability and performance data.  However, I can tell you that after at  least 
7 
ears of inserting pericardial aortic valves, the number of valves I've  
nserted that I've reoperated are probably no more than 2 or 3.  I fully  
ealize 
his is a very skewed, incomplete evaluation, but I would lay money that  15% of 
the valves I'm inserting aren't requiring reoperation at 7 years.  I  also 
nderstand that the numbers are exponentially worse at 10 years for  SPV.  I've 
eard from more than one source that Tirone is inundated with  SPV reops.  It's 
lso my understanding that he doesn't implant them  anymore.  Can you confirm 
r deny?
al

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