I don't accept those numbers for use in the way they're being presented here, as there's too little qualification as to what their frame of reference is. Statistics without qualification are utterly valueless, excepting for their use in rhetoric or propaganda. Thus Disraeli's "Lies, damned lies, and statistics."
On page seven, Dr. Emery states that "20 to 30%" of aortic tissue valve recipients are on Coumadin for other reasons, and "up to two-thirds or more" of mitral valve patients are on Coumadin.
Those do not come across to me as numbers, but rather as very loose estimates, and would be difficult to quantify, much less verify. Nor does he invoke an age group, study group, or any other qualifications.
Here's another quote from Dr. Emery. "When we look at quality of life as compared to the normal population, do you think that returning to the quality of life of a normal person after valve surgery is a fair requirement?"
Apparently, patients seeking a return to normalcy is not fair. Dr. Emery appears to excuse his specialty from the goal of the rest of medical science, in feeling that close enough should be seen as acceptable, perhaps admirable.
Does Dr. Emery really feel that way? Probably not. I hope not.
However, if I'm to believe the vague and "guesstimated" numbers in the first quote, should I not also take at unquestioned face value the uncaring pompousness of the second? Again, probably not. The point is that this is a surgeon, not an apostle. Not everything he says is valid out of context.
This is a group of gifted surgeons talking at a convention sponsored by the world's largest producer of mechanical valves. One brought a graph with him. As pointed out by another poster above, there are graphs available from reliable "scientists" (Dr. Emery's favorite validating word) that show "accurate" data all over the map for that question, and many others.
Remember, ten years ago these gifted individuals would have sworn to you that butter is the destroyer of your arteries, and you must stick to margarine. Now they will tell you that a little butter is okay, but you must stay away from the trans fatty acids and hydrogenated oils in margarines. The point? Certainly not to invalidate them. Just to point out that they succumb to marketing within their industry, too. They absolutely do want to advise the right things to their patients, but they're human, and they get fooled sometimes, too. By "scientists," no less.
I suspect a view of the data with the 75+ age group out would not bear out Dr. Emery's percentages. Conversely, in ages over 80, I'm going to guess 60% might be light. At those ages, I suspect the Coumadin numbers are nearly as high for those without AVRs at all.
Interestingly, these surgeons all seem to feel the tissue valves are superior for patients over 65, even though they expect that they most likely will wind up on Coumadin. And yet not necessarily for younger patients who very likely will not wind up on Coumadin at all before their resurgery. There's a mixed message for us.
Further, they discuss resurgery as being mostly an issue for institutions where resurgeries are seldom seen. Note to self: find competent surgeon and facility at resurgery time.
I don't care which valve type wins out, myself. If I can use the next On-X with just aspirin therapy, I'm fine with it. Delighted, in fact. That is being investigated, by the way.
However, I absolutely believe that "returning to the quality of life of a normal person after valve surgery" is not only a fair, but an achievable and absolute requirement for AVRs, MVRs, PVRs, and TVRs all.
On page seven, Dr. Emery states that "20 to 30%" of aortic tissue valve recipients are on Coumadin for other reasons, and "up to two-thirds or more" of mitral valve patients are on Coumadin.
Those do not come across to me as numbers, but rather as very loose estimates, and would be difficult to quantify, much less verify. Nor does he invoke an age group, study group, or any other qualifications.
Here's another quote from Dr. Emery. "When we look at quality of life as compared to the normal population, do you think that returning to the quality of life of a normal person after valve surgery is a fair requirement?"
Apparently, patients seeking a return to normalcy is not fair. Dr. Emery appears to excuse his specialty from the goal of the rest of medical science, in feeling that close enough should be seen as acceptable, perhaps admirable.
Does Dr. Emery really feel that way? Probably not. I hope not.
However, if I'm to believe the vague and "guesstimated" numbers in the first quote, should I not also take at unquestioned face value the uncaring pompousness of the second? Again, probably not. The point is that this is a surgeon, not an apostle. Not everything he says is valid out of context.
This is a group of gifted surgeons talking at a convention sponsored by the world's largest producer of mechanical valves. One brought a graph with him. As pointed out by another poster above, there are graphs available from reliable "scientists" (Dr. Emery's favorite validating word) that show "accurate" data all over the map for that question, and many others.
Remember, ten years ago these gifted individuals would have sworn to you that butter is the destroyer of your arteries, and you must stick to margarine. Now they will tell you that a little butter is okay, but you must stay away from the trans fatty acids and hydrogenated oils in margarines. The point? Certainly not to invalidate them. Just to point out that they succumb to marketing within their industry, too. They absolutely do want to advise the right things to their patients, but they're human, and they get fooled sometimes, too. By "scientists," no less.
I suspect a view of the data with the 75+ age group out would not bear out Dr. Emery's percentages. Conversely, in ages over 80, I'm going to guess 60% might be light. At those ages, I suspect the Coumadin numbers are nearly as high for those without AVRs at all.
Interestingly, these surgeons all seem to feel the tissue valves are superior for patients over 65, even though they expect that they most likely will wind up on Coumadin. And yet not necessarily for younger patients who very likely will not wind up on Coumadin at all before their resurgery. There's a mixed message for us.
Further, they discuss resurgery as being mostly an issue for institutions where resurgeries are seldom seen. Note to self: find competent surgeon and facility at resurgery time.
I don't care which valve type wins out, myself. If I can use the next On-X with just aspirin therapy, I'm fine with it. Delighted, in fact. That is being investigated, by the way.
However, I absolutely believe that "returning to the quality of life of a normal person after valve surgery" is not only a fair, but an achievable and absolute requirement for AVRs, MVRs, PVRs, and TVRs all.
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