AW: AW: [HSF] New crazy operations and solutions at HZL

[Tea Acuff]

I agree with the last part. We are a long way. If I may let me propose a more fundamental problem than the needs of the network of builders. Not only is a system needed to build a valve (or heart as in LVAD, etc), but what we are trying to build is itself part of a system. That is, multiple other interactions that we do not plan for are simultaneously occuring. A valve is not just hydrodynamic, but rheodynamic, immunodynamic, possible needing to grow, in short, needing to conform in ways that are not clear but cause individual failures. This is why repair tends to "function" better than replacement, why tissue even if less durable is more biologically friendly, and in line with this logic biological interactive (especially "autologous") solutions or replacements will always in the end out perform mechanical replacements.

Or as I say the world is not flat (or even Cartesian). It is round as in a complex system.

tea


----- Original Message ----
From: "Rwmfglycar at aol.com" <Rwmfglycar at aol.com>
To: OpenHeart-L at lists.hsforum.com
Sent: Friday, April 25, 2008 5:42:29 PM
Subject: Re: AW: AW: [HSF] New crazy operations and solutions at HZL


In a message dated 4/25/2008 10:14:24 A.M. Eastern Daylight Time,  
tacuff at swbell.net writes:

So what  do you think about your 1960 pronouncement 50 years later both 
specifically  and generally, Bob?

tea



Obviously I was pretty naive but it did me good to have my  careless 
statement criticised. I would not have believed then that 48  years later we would 
still be so far from achieving the goals we laid down for  ourselves then. Some 
of us actually already understood what in  principle we needed to know in order 
to achieve those goals. The truth is  that we still fall very far short of 
understanding  the basic  science essential  to do the job of producing the 
perfect valve  replacement.
One of the conundrums is that valves need industry for development and  
industry needs early profit. Radical innovation does not come from this  equation. 
If you look at valves that have made it through to regular use in  recent 
decades they usually have no more than one new or special feature to  distinguish 
them from others. Sometimes it is no more than a different way to  put the 
valve in or a conformation of the inflow to produce more laminar flow;  the kind 
of change that might be described as a key marketing feature.  Roberto quoted 
Kuhn. My opinion is that we are nowhere near a revolutionary  paradigm shift 
of the kind that he described. 
Bob



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