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

[Ani Anyanwu]

> > Ani,> Not to quibble, but the CCF paper you cited had more AI than AS as the > cause of failures in pericardial valves. > > Hal> 
 
Yes Hal which is why I said that the teaching pericardial fail by stenosis, porcine by regurgitation does not reflect the whole truth but only part of the truth. 
 
There is however an association. Just like with Bicuspid valves = aortic stenosis hypothesis. Most bicuspid valves will never be stenotic and most stenotic valves are not bicuspid but that does not mean stenosis is not a more frequent occurrence in bicuspid valves than tricuspid valves (as we know it is).
 
I will however say that our recollections are tainted by our biases. I suspect if you objectively looked at your data *on reop avrs* you would find very few cases where a porcine valve was replaced for pure stenosis (i.e. the integrity of the cusps was maintained). Now you have heard tom martin mention this you will probably start seeing the converse and noticing most porcine valves you explant *for structural degeneration* do calcify, leak and have torn cusps. Indeed part of the reason you may not have observed this is because your experience in rereplacing pericardial valves is comparatively limited compared to porcine (i think you have said in the past that you have only seen a handful of pericardial valves come back for degeneration, but done loads of porcine). Another thing possibly tainting your observation is your large volume mitral practice. These observations apply to the aortic position - in the mitral position it is rather different and porcine valves do also stenose.
 
Ani
 



> From: Hgrmd at aol.com> Date: Wed, 2 Jan 2008 07:31:44 -0500> Subject: Re: [HSF] re: Porcine vs pericardial for Hal and others> To: OpenHeart-L at lists.hsforum.com> CC: > > > **************************************See AOL's top rated recipes > (http://food.aol.com/top-rated-recipes?NCID=aoltop00030000000004)> _______________________________________________> 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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