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

[Prasanna Simha M]

I would say depends on what is available. The homograft  is still the tissue
of choice if available .
Prasanna

On Jan 3, 2008 12:19 AM, <zzhoumd at pol.net> wrote:

>
> Now I have a patient with root abscess from enteroccocus. Which valve to
> use, homograft vs freestyle bentall?
>
> Z Zhou
>
>
> Sent via BlackBerry by AT&T
>
> -----Original Message-----
> From: Ani Anyanwu <anianyanwu at hotmail.com>
>
> Date: Wed, 2 Jan 2008 15:16:05
> To:<openheart-l at lists.hsforum.com>
> Subject: RE: [HSF] re: Porcine vs pericardial for Hal and others
>
>
> > > 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: > > >
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-- 
Prasanna Simha M