[HSF] Fwd: HSF Pericardial and porcine

[rwmfglycar at aol.com]

-----Original Message-----
From: rwmfglycar at aol.com
To: openheart-L at lists.hsforum.co9m
Sent: Wed, 2 Jan 2008 7:06 pm
Subject: HSF Pericardial and porcine


There is a real problem with these discussions on Pericardial and Porcine valves and their reputed long term results and failure modes. They are being treated as though they and their use are generic.
The behaviour of both porcine and pericardial valves is design, material and fabrication dependent. Disappointigly for those who think? the world is perfect or wish it were, named valves have had subtle variations in their quality in both good and bad directions?during their?time in production. And, of course, for?any brand, ?patient age and other patient factors may?influence performance, (but not always consistently). All of this makes a mockery of confident assertions about what surgeon and patient can expect from type of valve "x" in patient "y". And note that I have not even included what? some surgeons (HSF members excepted)?manage to do with the valves they implant.
I tried in a small way to follow all the valves I implanted to failure or patient death. Anything less than that is nothing more than an incomplete glimpse of the truth.
Of course I did not succeed in this venture but I came to some conclusions which I shall deal with in another letter.
Bob
P.S. Just to clarify one point, the term stenosis refers to obstruction to flow. In rheumatic and some congenital disease this is caused by leaflet fusion. Leaflet stiffness (due to calcific or fibrotic change) without any fusion of leaflets,?is equally a cause of obstruction to flow and may also?be called stenosis


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