Sunday, September 7, 2008

Pondering valve options

I am compiling a list of questions to ask the cardiologist on Monday and the surgeon in a few weeks. Here they are so far:

Regarding Seattle Plan A:
1) If BAV is a connective tissue disorder causing dilation of the aortic root, what complications would this cause with a bio-prosthetic valve replacement?

2) In your experience, what is the likely lifespan of a bio-prosthetic valve from either deterioration or being outgrown?

3) What size valve is likely to fit Wren and what are the techniques and risks of inserting a larger valve in this position?

4) What procedure will be used for the sub and supra valvular stenosis (patch? carving?)

5) What is an average recovery time for this procedure?

6) Could you put me in touch with someone who can give me information on the Number of cases and outcomes for this procedure?

Regarding Stanford Plan A (save valve):

1) Given the proximity of the subaortic stenosis (SAS) to the valve, how do you think you will be able to get enough of the obstruction?

2) Why would we NOT want replacement of the AV with bio-prosthetic valve if its compromised? What are risks? Future implications?

3) What would you hope be regarding the lifespan of this valve considering it has already had intervention [cath] and leaflets appear thickened?

4) What is the likely recovery time for this procedure?

5) Could you put me in touch with someone who can give me information on the Number of cases and outcomes for this procedure?

6) What procedure will be used for the sub and supra valvular stenosis (patch? carving?)

Regarding Stanford Plan B (Ross-kono):
1) How concerned are you about early failure of the pulmonary autograft in patients with with BAV?

2) What about the risks of increasing from a two-valve pathology [aortic and mitral] to a three-valve problem?

3) Number of cases and outcomes for this procedure?

4) How concerned are you about the effects of multiple passes on bypass?

5) What is the likely recovery time for this procedure?

6) What procedure will be used for the sub and supra valvular stenosis (Kono element enlarges ... how exactly)

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