[HSF] AI and ASC AO Aneurysm s/p Ross procedure

Sat Sep 8 10:48:18 EDT 2007

Hal
I wasn't suggesting that tissue valves were the only way to go. In fact I too would strongly suggest a mechanical valve in this situation. However if the pt was adamant that they didn't want a mechanical valve for whatever reason, then various tissue valves/techniques should be considered. In young pts which this pt would still be at his 3rd op, if the cardiac function is still good and there are no other really bad comorbidities then the M&M in our hands doesn't seem to be that much worse.

Tom

-----Original Message-----
From: Hgrmd at aol.com
To: OpenHeart-L at lists.hsforum.com
Sent: Fri, 7 Sep 2007 6:54 am
Subject: Re: [HSF] AI and ASC AO Aneurysm s/p Ross procedure

Tom and Carmi,
  I have to agree with Dr. Salerno that the patient should strongly  consider 
getting a mechanical Bentall.  At his tender age, it is almost  guaranteed 
that he will outlive a tissue valve.  The 3rd time in will carry  a hefty M and 
M.  
  BTW, I was thumbing through the September issues of Annals last  night and 
came across Tirone David's group's report of redo stentless  valves.  Most 
were SPV's, though a few were Freestyles.  The thrust of  the article was that 
this is a technically difficult, high risk procedure that  usually entails root 
replacement.  To me, that's just another reason that  one should think long 
and hard before implanting a stentless valve, particularly  full root.  To me, 
it just doesn't seem justified to take out a normal root  in the quest to 
implant a stentless valve.

Hal

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