Anticalcification Processes

[Dirk]

I found the following interesting papers on anticalcification processes on tissue valves:

http://www.ncbi.nlm.nih.gov/entrez/...ve&db=pubmed&dopt=Abstract&list_uids=10218616

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=9930458


They include inforatmion on the AOA from Medtronic and the BiLinx form SJM.

No informaion on Carpentier-Edwards processes.

This does also not really help:

http://www.ncbi.nlm.nih.gov/entrez/...ve&db=pubmed&dopt=Abstract&list_uids=15008695


Greetings

Dirk

 

[Phyllis]

Dirk,
I'm afraid the true test is on us humans and we won't know the results of the Edwards new treatment for 10-20 years out. Here's an interesting link:
http://160.94.126.215/CPL11.pdf
Especially note the conclusion at the end.

 

[Mary]

I hope you guys get this all figured out before I have mine replaced. I'm going to ask for a definitive answer from the group (pgruskin, Dirk, Tobagotwo, and Papa) and I hope you will have reached a consensus of opinion.

I'm going to relax and take it easy until then.
Mary

 

[PapaHappyStar]

I wouldnt accept a single right answer anyway, depends upon age, valve type, gender, hospital, surgeon ( not to mention the phase of the moon ).

Dont know if I'll be able to make up my mind in time, but studying it is probably my way of keeping relatively sane about the whole process anyway...

 

[Phyllis]

There are no single answers, as this forum will attest to! But knowledge is empowerment and it sure is nice to be able to help each other try to figure it all out.

 

[Bryan B]

Burair,

I did a lot of research to pass the time. I ended up choosing the Ross beacause I had a gut feeling. All that research on mechanical, tissue, homograft, and autograft and I ended up making up my decision all of a sudden on a gut feeling...mostly about the surgeon doing it. Then I had to go through the entire process of picking a backup in case he got in there and couldn't do the Ross. CE pericardial bovine was my backup plan, and if for some reason he couldn't do that a St. Jude Regent mechanical. Thank goodness he said that once he got in there that I was a perfect candidate for the Ross, but I was prepared to wake up with either of the three valves. It was the first question I asked when I was extubated.

 

[Dirk]

I am currently investigating a new valve from 3F-Therapeutics:

http://www.3ftherapeutics.com/

clinical trials are already running since 2 years and they are promising.


And there is the new polyurethane valve with finest German engineering (first trials will start in 2005):


http://www.adiam.de/index_e.htm

http://www.ncbi.nlm.nih.gov/entrez/...ls.org/cgi/pmidlookup?view=full&pmid=12970222

http://www.ncbi.nlm.nih.gov/entrez/...ve&db=pubmed&dopt=Abstract&list_uids=15144993


And kangarooh valves:

http://www.icr-heart.com/journal/abstracts/july2004/article22.html

Greetings


Dirk

 

[Mary]

Bryan,
I intend to have the Ross myself, but I'm thinking about the backup if we get in there and it can't be done.
Whatever the surgeon decides to replace it with is what I get, but it would be nice to have an opinion in the event it was needed.
I've told Tobagotwo before that discussions about types and models of valves reminds me of discussions about makes and models of cars.
I'm not really concerned with the merits, but I'm glad someone out there is.
As I said previously, you guys continue to investigate and explore the research, so I can pluck your brains when the time comes!
Thank you in advance!
Mary

 

[PapaHappyStar]

I think I might be a good candidate for the Ross, but havent decided yet -- I think the most important decision to make in this case is the choice of surgeon. For backup, right now probably a tissue valve ... I think there is a greater diference in risk of stroke btw. bio-prosthesis and mech. than published, but I havent looked into this enough to satisfy myself ( other things to consider are operative ease and risk + need for early resurgery, is there anything else?? probably -- need feedback/further study ) For me the risk of earlier resurgery with bio-valves is less scary than the thought of a greater risk of an irreversible embolic stroke event ( I havent quatified this -- there probably is an actuarial analysis one could do .... but then again the answer is not too definitve, at best just indicative ), mostly personal opinion right now.

I think the particular choice of valve model is not so important, barring any revolutionary breakthrough improvements are marginal... but its good to keep an eye/ear open to news.

Sorry for this scatterbrained analysis ... I am babysitting my son today ( typing with one hand takiing breaks to amuse him ... among other unmentionable details )

 

[tobagotwo]

Dirk,

However, the polyurethane valve may be the one sold to a German company by a company in Australia. Here's a link: http://www.valvereplacement.com/forums/showthread.php?p=87007#post87007post87007

Adiam looks very interesting, but be sure of their claims. Prior claims made concerning polyurethane products and no requirement for anticoagulation had to be retracted, as they proved to be simply incorrect. I note no links for long-term studies on their site, which is set up entirely for marketing. There is also no real detail on the valves, other than a general description. I would like this to be true as well, but please be careful here.

Best wishes,

 

[Dirk]

Bob:

Adiam is a spin-off company of somebody who developed these valves for use in artificial hearts.

I guess there is no relation to the Australian company.

I agree fully with your other arguments.



Dirk