[HSF] Mitroflow valve

[Ani Anyanwu]

Carmi
 
Would you try a new valve purely on the recommendation of a rep? That the valve looks nice, is easy to implant and has low gradients may be nice points, but should those be what determines which valve we use? I remember in the late 1990s at Harefield we switched to the Biocor for these very reasons and within 2 years we had explanted 3 for structural valve degeneration.
 
The reps will tell you what they want you want to hear. For example while mitroflow rep will likely present Yankah's outstanding series with 95% free from SVD at 17 years, the Edwards reps will present you with minami's data which shows 77% freedom from SVD at 10 years, or if they want to really put you off, Houel's data which shows 56% free from SVD at 10 years. If you are still to make up your mind, the Edward's rep will probably give you a copy of Houel's paper whose title alone - "Lack of durability of the Mitroflow valve does not affect survival" - might scare you into submission. The Mitroflow rep might take to the challenge and present the Cleveland clinic paper "Failure modes of the Carpentier-Edwards pericardial bioprosthesis in the aortic position" to remind you that the perimounts fail too, so much so that cleveland clinic published a series of 95 such reoperations (20% of their initial perimount cohort). So really unless you investigate yourself you may never find the "truth" ... that is if the truth is known. As Dr Frater pointed out the issues regarding sizers and gradients are even more murky and all reps will have some data they can provide to make their product look superior.
 
The mitroflow has been in use since the 1980s, as has the perimount, and there are several longterm studies of their outcomes - at least you should look at these studies before deciding to switch?  
 
Ani
 



> From: Cysmd613 at aol.com> Date: Wed, 21 Nov 2007 11:46:14 -0500> Subject: Re: [HSF] Mitroflow valve> To: OpenHeart-L at lists.hsforum.com> CC: > > Our local Carbomedics/Sorin rep just stopped in my office to tell me about > the mitroflow aortic valve. It looks like a very nice valve with a very > flexible sewing ring and reportedly low transvalvular gradients. He says that a 23mm > mitroflow valve would fit in an annulus where only a 19 perimount valve would > fit. I plan to use one on my next AVR.> > Carmi > > > > **************************************Check out AOL's list of 2007's hottest > products.> (http://money.aol.com/special/hot-products-2007?NCID=aoltop00030000000001)> _______________________________________________> OpenHeart-L mailing list> > Send postings to:> OpenHeart-L at lists.hsforum.com> > To UNSUBSCRIBE, to CHANGE email address, or to view archives:> http://mmp.cjp.com/mailman/listinfo/openheart-l> > All messages transmitted by the OpenHeart-L are subject to the policies and > disclaimers posted at:> http://www.hsforum.com/listdisclaim> -----------------------------------------
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