Re: [HSF] longevity of bioprostheses

[tdmartin2000 at aol.com]

Hear, Hear!!


-----Original Message-----
From: rwmfglycar at aol.com
To: OpenHeart-L at lists.hsforum.com
Sent: Thu, 3 Jan 2008 3:01 pm
Subject: Re: [HSF]　longevity of bioprostheses



Giulio,
hy would he ever receive a new prosthesis?
here are two ways of looking at this:
) make a decision in which the desires and interests of the patient are 
aramount;
) make a decision in which the total population interests are paramount.
ystem a) is the traditional way, at one time controlled by the conscience and 
thics of doctors, but now rendered very complicated by efforts to protect 
atient interests and remove power from single individuals.
ystem b) is what happens when health is totally controlled and financed by the 
tate. The Minister or Secretary or Gauleiter of Health asks the question: how 
re the interests of the total population served by spending x thousands of 
urrency on this one patient versus spending them on something else e.g. 
accines for homeless children?
 In this case the answer under system b) is clearly no device replacement. 
nder system a) the outcome is not clear. Dementia excludes the patient from the 
ecision. I would not hesitate to say that there can be no good in putting a 
emented patient through a rereplacement. But there are many reasons including, 
n some parts of the world, the exchange of money that might result in a repeat 
rocedure.
ob

----Original Message-----
rom: Giulio Rizzoli <giulio.rizzoli at unipd.it>
o: OpenHeart-L at lists.hsforum.com
ent: Thu, 3 Jan 2008 11:57 am
ubject: Re: [HSF]　longevity of bioprostheses

t 17.20 03/01/2008, you wrote: 
I have always been wondering what the real longevity of bioprostheses is. 
Because for example, if you put pericardial valve at the age of 70, then the 
patient become 85 yo with low ADL and dementia, and also develop gradual AS, 
not acute AR due to breakdown of prosthesis, probably reoperation is not 
performed. 

e could probably receive a percutaneous new prosthesis via phemoral or cardiac 
pex 
 Giulio Rizzoli 
iulio Rizzoli MD FETCS 
ardiochirurgia Padova 
el. 049 821-2408 
ax 049 821-2409 
-mail giulio.rizzoli at unipd.it 

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s war ein Traum .... Heinrich Heine 


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