[HSF] AORTIC VALVE REPLACEMENT

[DukeB60 at aol.com]

Gustavo,    
    I have replaced the aortic valve for the last 17  years with three 3-0 
prolene sutures with the technique I learned from Donald  Doty and still do it 
exactly as shown in his surgical atlas.  The argument  against is the fear of 
perivalvular leak but I have not seen that issue if you  are careful to take 
good bites and are diligent in debriding the annulus  and in snugging the 
sutures down before tying them.  It is quicker,  allows the use of the suture for 
retraction to gain visibility of the annulus  and I like only having to tie 
three knots.   The only time I don't use  the technique (maybe once or twice) is 
if the annulus is very calcified and  can't be debrided adequately and I fear 
the calcium cutting the prolene.   You have to be careful not to ever grasp or 
fracture the prolene but with  the right technique I have found it to be a 
very reliable approach.  
 
 
                                                                              
                                      Ed
 
Edward P. Raines, M.D., J.D.
BryanLGH  Cardiothoracic Surgery
BryanLGH Medical Center East 
1600 South 48th  Str.
Lincoln, Nebraska 68506
Office: 402-481-8430
Cell:  402-730-9242
Fax: 402-481-8429



In a message dated 3/19/2008 8:14:48 P.M. Central Daylight Time,  
gabuin at intramed.net writes:

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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