[HSF] re: Porcine vs pericardial for Hal and others

[Prasanna Simha M]

Many of the Titles do not mention it but when we go into the data of
thearticles there is a significant  amount of both regurgitant and stenotic
valvar degeneration. For eg the article belwo doesn't mention it but then in
the analysis it does mention stenotic degeneration.
I have seen both modes of failure and both occur in both pericardial and
porcine valves. The exact ratio  may vary depending on the age renal
function etc etc.
Take for eg the old Liotta bioprosthetic valve which degenerated rapidly.
Most were regurgitant but there were stenotic degenerations in quite a few.
Prasanna

Tex Heart Inst J. 1988; 15(1): 25–30.
Hancock Bioprosthetic Valve Failure
Causes, and Results of Reoperation
Uberto Bortolotti, MD, Aldo Milano, MD, Alessandro Mazzucco, MD, Francisco
Guerra, MD, Alberto Magni, MD, Gaetano Thiene, MD, and Vicenzo Gallucci, MD

"Morphologic studies of the explanted valves revealed that tissue
calcification is the most frequent cause of primary tissue failure in
Hancock-valve recipients. Calcification leads to cusp stiffening with
stenosis or to cuspal and commissural rupture with incompetence."


On Jan 2, 2008 8:36 AM, Ani Anyanwu <anianyanwu at hotmail.com> wrote:

> Hal
>
> This would be most unusual as there are no reports I can find of stenosis
> as a dominant cause of failure of porcine valves - many papers do not report
> stenosis at all as a mode of failure in their porcine explants. Most series
> report calcification and cusp tears as cause of failure in the vast majority
> and of course this is the reason why anti-calcification therapy is touted as
> the magic that will improve longevity of porcine valves.
>
> Are you including valves that you took out because they were undersized
> (relative stenosis or so called patient-prosthesis mismatch) or are these
> valves which were truly stenotic with fused leaflets with restricted motion.
> Do you usually see calcification in these stenotic porcine valves?
>
> Ani
>
>
>
>
>
> > From: Hgrmd at aol.com> Date: Tue, 1 Jan 2008 21:46:32 -0500> Subject: Re:
> [HSF] re: Porcine vs pericardial for Hal and others> To:
> OpenHeart-L at lists.hsforum.com> CC: > > Tom,> I don't know that I buy what
> the reps say. I think I've taken out more > stenotic than regurgitant
> senescent porcine valves. > > Hal> > > >
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-- 
Prasanna Simha M