[HSF] Aortic Regurgitation in 16 year old

Tea Acuff tacuff at swbell.net
Fri Nov 16 20:47:49 EST 2007


At the uses of extracellular matrix, marketed presently as Cor Matrix. It is available for the looking. I will turn this into a different thread.

tea


----- Original Message ----
From: "rwmfglycar at aol.com" <rwmfglycar at aol.com>
To: OpenHeart-L at lists.hsforum.com
Sent: Friday, November 16, 2007 3:56:26 PM
Subject: Re: [HSF] Aortic Regurgitation in 16 year old

Where?


-----Original Message-----
From: Tea Acuff <tacuff at swbell.net>
To: OpenHeart-L at lists.hsforum.com
Sent: Wed, 14 Nov 2007 7:03 pm
Subject: Re: [HSF] Aortic Regurgitation in 16 year old



Which is why you will be pleasantly surprised if you look there.

tea


----- Original Message ----
From: "rwmfglycar at aol.com" <rwmfglycar at aol.com>
To: OpenHeart-L at lists.hsforum.com
Sent: Wednesday, November 14, 2007 3:00:50 PM
Subject: Re: [HSF] Aortic Regurgitation in 16 year old

Not odd. Been hoping to achieve this for close to 50 years. But something less 
than the goal is what is usually achieved. You need to know that the response of 
the heart to materials inserted? into it varies according to the location and 
function. The FDA 510k?approval system does not allow for such subtleties. It 
remains up to us (Hooray) to apply our intellects to determine what use is 
appropriate. My questions remain to be answered.
Bob


-----Original Message-----
From: Tea Acuff <tacuff at swbell.net>
To: OpenHeart-L at lists.hsforum.com
Sent: Wed, 14 Nov 2007 2:05 pm
Subject: Re: [HSF] Aortic Regurgitation in 16 year old



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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