[HSF] Aortic Regurgitation in 16 year old

Wed Nov 14 11:05:14 EST 2007

This is a rather odd situation. Maybe I should refocus on the environment rather than the situation. The regulatory environment is rather odd. The extracellular matrix has been approved for "intra cardiac use" as are other "patch" material.  
There are no studies of its long term function (structure), but the interesting thing is that the short term observation is that this material, which is the matrix or the roadside commerial real estate of the body, if you will, turns into the tissue that it replaces and is in contact with. In this case histologically becoming  normal valve tissue if applied in a suitable manner.
 This a very peculiar and interesting field of study. That few in cardiac surgery found it so, only underscores the problem of tautology, or the boundaries of the types of thinking that we bring to our methodologies, in our studies. 

tea

----- Original Message ----
From: "rwmfglycar at aol.com" <rwmfglycar at aol.com>
To: OpenHeart-L at lists.hsforum.com
Sent: Tuesday, November 13, 2007 11:27:39 PM
Subject: Re: [HSF] Aortic Regurgitation in 16 year old

Tested means experiments to determine, as far as you can,?its behaviour as a leaflet if you are going to use it as a leaflet. It means knowing its behaviour in juveniles if you are going to use it in juveniles.
Bob

-----Original Message-----
From: Tea Acuff <tacuff at swbell.net>
To: OpenHeart-L at lists.hsforum.com
Sent: Tue, 13 Nov 2007 10:39 pm
Subject: Re: [HSF] Aortic Regurgitation in 16 year old

That depends on what you mean by tested. It has been used in a variety of 
anatomical positions. I'll forward your request to Rob Matheny the founder of 
Cor Matrix.

tea

----- Original Message ----
From: "rwmfglycar at aol.com" <rwmfglycar at aol.com>
To: OpenHeart-L at lists.hsforum.com
Sent: Monday, November 12, 2007 10:43:22 PM
Subject: Re: [HSF] Aortic Regurgitation in 16 year old

Tea 
Where can one find data on the Cor matrix pericardial substitute? Hasitbeen 
tested other than as a cover for the heart?
Bob

-----Original Message-----
From: Tea Acuff <tacuff at swbell.net>
To: OpenHeart-L at lists.hsforum.com
Sent: Mon, 12 Nov 2007 5:35 pm
Subject: Re: [HSF] Aortic Regurgitation in 16 year old

Bill, or Prasanna for that matter,
If you are looking at tissue extension for leaflets have you looked at the Cor 
matrix (extracellular matrix) "pericardial" substitute?

tea

----- Original Message ----
From: "rwmfglycar at aol.com" <rwmfglycar at aol.com>
To: OpenHeart-L at lists.hsforum.com
Sent: Monday, November 12, 2007 1:20:41 PM
Subject: Re: [HSF] Aortic Regurgitation in 16 year old

These cases are very pathology dependent. The thicker the leaflets the more the 
difficulty. I never was too happy with leaflet unfurling.
Pericardial leaflets in a goretex tube very interesting,

Bob

-----Original Message-----
From: ICHFNO at aol.com
To: OpenHeart-L at lists.hsforum.com
Sent: Mon, 12 Nov 2007 12:38 pm
Subject: [HSF] Aortic Regurgitation in 16 year old

The child with aortic regurgitation I presented last week was operated on  
today. Leaflets were rolled and thickened severely, as with RF. Initially we did 

3 leaflet thinning and leaflet augmentation with glutaraldehyde fixed 
autologous  pericardium. Gave the CP upon aortic closure and at low flow rate 
competency was  noted, but at high flows had some LV distention. Removed the 
clamp, 
and once the  heart was beating TEE showed moderate residual AI. Did a Ross. 
Made a  trileaflet valve from Goretex and remainder of pericardium for conduit. 
Off with  trivial AI and RV Valve conduit gradient of 5 by direct 
measurement. This is the  2nd one in a row we have had to convert to a Ross 
after failed 
leaflet  extension, must be doing something wrong!

Bill

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