interesting video here about valve choices

[ashadds]

This guy seems to hate a mechanical valve

 

[Todd]

Wow, I don't think I should have watched this ! I have a surgery coming up at the end of this month, my 3rd Aorta valve replacement and I am choosing to go mechanical . Watching this makes me second guess my decision .

 

[pellicle]

. Watching this makes me second guess my decision .

Don't.

This sort of thing has a bunch of assumptions in it and ignores data. Your choice is carefully thought out for your specific situation. You have additional data and criteria.

I didn't go through it but did it address Lp(a)?

What was it's assumption on anticoagulation?

May as well go listen to a valve makers sales pitch (hint, it will be what they have the biggest margin in).

 

[pellicle]

Wow

wow is how I usually feel when digging into the details ... most "pro one side" stuff was "pro bio-prosthesis" then became "pro-TAVR" ... its interesting how that goes when TAVR maximises profits and minimises hospital time so that insurance companies can green light it for "those who it was never intended for"

Lets look into this:

Aortic Valve and Ascending Aorta Guidelines for Management and Quality Measures
Lars G. Svensson MD PhD Chair Writing Committee; David H. Adams MD Vice-Chair Writing Committee; Robert O. Bonow MD Vice-Chair Writing Committee; Nicholas T. Kouchoukos MD Vice-Chair Writing Committee; D. Craig Miller MD Vice-Chair Writing Committee; Patrick T. O'Gara MD Vice-Chair Writing Committee; David M. Shahian MD Vice-Chair Writing Committee; Hartzell V. Schaff MD Vice-Chair Writing Committee; Cary W. Akins MD Writing Committee Member; Joseph E. Bavaria MD Writing Committee Member; Eugene H. Blackstone MD Writing Committee Member; Tirone E. David MD Writing Committee Member; Nimesh D. Desai MD PhD Writing Committee Member; Todd M. Dewey MD Writing Committee Member; Richard S. D'Agostino MD Writing Committee Member; Thomas G. Gleason MD Writing Committee Member; Katherine B. Harrington MD Writing Committee Member; Susheel Kodali MD Writing Committee Member; Samir Kapadia MD Writing Committee Member; Martin B. Leon MD Writing Committee Member; Brian Lima MD Writing Committee Member; Bruce W. Lytle MD Writing Committee Member; Michael J. Mack MD Writing Committee Member; Michael Reardon MD Writing Committee Member; T. Brett Reece MD Writing Committee Member; G. Russell Reiss MD Writing Committee Member; Eric E. Roselli MD Writing Committee Member; Craig R. Smith MD Writing Committee Member; Vinod H. Thourani MD Writing Committee Member; E. Murat Tuzcu MD Writing Committee Member; John Webb MD Writing Committee Member; Mathew R. Williams MD Writing Committee Member

ATS, 95 (2013) S1-S66. doi:10.1016/j.athoracsur.2013.01.083
(that doi can be searched on) if you do, you'll find this table:

So that's pretty sloppy stuff because All and Total just don't add up

Putting that data into a spreadsheet I get this:

Valve​	​	Number​
Mechanical​	​	​
​	all​	16,780​
Tissue​	​	​
​	ATS​	216​
​	Carbomedics​	5,290​
​	Edwards​	39,367​
​	Medtronic​	18,688​
​	St Jude​	11,666​
​	SUM​	75,227​
​	​	​
​	Mech + Tissue​	92,007​

The All in tissue does not fit in with the spreadsheet (so I've omitted it), despite formatting the All indented under Tissue is actually close to the Sum of the provided Tissue groups but not quite right ... sloppy.

I see this again and again in medical stuff and it wouldn't fly in Engineering or any Science paper. You'd be ridiculed and hammered ... so far I'm the only one on the internet I can find taking issue with that.

Standing on the shoulders of Giants ... huh ... now, getting back to that look at the amount for Tissue valve costs $435,716,947.00 ... ho lee sheet ... that's $435Million which almost certainly doubles itself with repeat business. Follow the scent of money I say.

I've written about that in this lengthy post:
https://cjeastwd.blogspot.com/2014/01/heart-valve-information-for-choices.html

Best Wishes