[HSF] AORTIC VALVE REPLACEMENT

[Prasanna Simha M]

2/0 nonpledgetted sutures each arm passed from LVOT side to aortic
side of the annulus. I used to use the classical everting pledgetted
sutures before but changed as I observd that you can consistently put
a larger size valve and I have anecdotal experience that it reduces
tha amount of Pannus. One thing is that the aortic annular rim must be
kept thin by meticulous excision with this technique.
When I was training we used to use the continuous prolene suture
technique which I feel should not be used as there is documentation of
a higher paravalvar leak rate.I think a ddramatic example was the case
which was presented to me at Croatia  where a patient had multiple
redos of the mitral vavle and the last one done in a London Hosptal
was done with a 2/0 Prolene 3 suture continuous technique and
developed a late paravalvar leak years after the original surgeryand
there was suture dehiscence.
Prasanna

On Thu, Mar 20, 2008 at 6:39 AM, gustavo abuin <gabuin at intramed.net> wrote:
> Dears members of the forum.
>  I ussually perform my aortic valve replacement using 2-0 not pledgetted
>  sutures of Ethibond.
>  Sometimes (large annullus) I use pledgetted sutures.
>  What´s your preffered technique?
>  Why?
>
>  Does any of the members of the forum replace the aortic valve with prolene
>  in with 6  2-0 prolene sutures?
>  If so, why?
>  Thanks
>  gustavo
>
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-- 
Prasanna Simha M