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

[Tea Acuff]

I am not positing that you are wrong that the problem is "merely" lack of information and suitable manufacturing of your dream valve. The valve could possibily be better than the native design if "out living" the patient is a useful Cartesianesque variable. But whatever would that mean as viewed from where? I am just pointing out that this is YOUR and the popular Occidental dream view and may not be, if I might suggest for reference, the hearts or creatures dream. We have developed computers that can out calculate and organize us without doubt. But not only for the emotional reason, but the formal theoretic or logical reasons that i have argued elsewhere, would anyone prefer a computer for a brain? It is a fair question to beg, but I am not sure there is a good and new positive answer, as to whether a longer than life lasting valve or body is better than a living or life like one. Strange as it seems 50 years after your brave and naive dream, we now have
 in theory at least, some possibility to consider living biologic dreams along side the one that you posited long ago. 

One of the reasons that I keep talking though all this "non"sense is that it seems more efficient and more "intellegent" to think formally though these ideas as best we can before or certainly now as we apply them. I make many mistakes in thinking, but this seems less tragic than the mistakes that your friend suggests that he "visits from time to time" in his head, our patients from our collective past 50 years. Unfortunately we are caught in a trap where that which seems to work well and is presumbly the nature of things might be compared to another world path that we have not taken as quite different and preferrable over time. Remember the lesson of the black swan?

tea





----- Original Message ----
From: "Rwmfglycar at aol.com" <Rwmfglycar at aol.com>
To: OpenHeart-L at lists.hsforum.com
Sent: Sunday, April 27, 2008 3:11:42 AM
Subject: Re: AW: AW: [HSF] New crazy operations and solutions at HZL


In a message dated 4/26/2008 11:07:44 A.M. Eastern Daylight Time,  
tacuff at swbell.net writes:

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



Tea,
Do not agree with the first part? What we have here is a twofold problem:  
insufficient understanding of the basic science coupled with a system of  
development and production that cannot meet the complex needs of making the  ideal 
valve. However despite agreeing with your summary of those complexities I  will 
not dismiss from my mind the possibilty that a mechanical valve could  
produce performance undetectably different from the best biological solution.  How 
about a  mechanical valve that would outlast a normal human  lifespan, have no 
hemolysis, no detectable emboli, no need for anticoagulants  and hemodynamics 
that would allow ventricles to recover to a normal state  if not put in too 
late?
Bobh



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