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J Thorac Cardiovasc Surg 2008;135:24
© 2008 The American Association for Thoracic Surgery

Surgery for Acquired Cardiovascular Disease

Discussion

Dr Arvind Koshal (Edmonton, Alberta, Canada). Thank you very much, Dr David, for an excellent presentation. This is an excellent example to all of us of how you took a product from the initial development stage, brought it into the market, and are now providing us with 100% follow-up on these 357 patients. You should be congratulated for doing that and giving us a lot of information.

It is interesting that the survival has been good despite a durability issue that we have seen with tissue valves in the past. The difference, though, in using stented valves with poor durability was that at the time of reoperation, the reoperation was not that technically complicated. What were the technical problems on reoperation in these patients who have a more complex way of insertion and also where coronary ostia and sinuses are involved? What kind of valve or conduit do . . . [Full Text of this Article]

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