thanks for sharing this one ... very interesting
now that I've had time to watch it and assemble my thoughts I have some 'review' of that video
The Good:
the idea of being able to simply sock and support the aorta is an excellent one. That one can have ascending aorta supported without valve replacement (should valve replacement not be needed) is great.
However I wonder (for us valvers) how often that actually is? The fellow giving the Talk (Tal Godsworthy?) has Marfans syndrome, which is of course different to those of us who have BAV which seems to lead to dilation of the ascending aorta in many of us. So our situations are different.
the bad:
I discovered on careful listening that he starts out with this
shock horror story of having his chest opened up (appeal to the hysteria). He uses appeal to emotion (horror) in his description of the 'on offer' treatment with the anesthetize you, open your chest put you on an artificial heart lung machine .... but then when he describes his own procedure he says "installation is quite easy" ... yet it still requires his chest be opened up (and I hope he was anesthetized for that).
True you do save your own aorta and do not compromise the vascular system, which is great.
His description of "replace it with a plastic valve and a plastic aorta" is also to me quite wrong.
I noted that on his slide the antibiotic therapy is NO .. hmm ... I have my own opinion of the benefits of that (considering the real risks of antibiotics are minimal with people seeking them for a cold even) and in fact he tries to make his chart longer but in fact has just three really good points on his chart (
which are good points!!)
Then he also talks about warfarin as if its mandatory, which is not my understanding. I would be pleased if anyone can actually set me straight here, but it was my understanding that ascending aorta could be grafted without you being on warfarin. I assumed that (for instance) even if the valve had to be replaced (
and does it?) a tissue valve could be used and thus his having to be on warfarin is a bit of a skeleton rattle.
Next he says that while the thought of the surgery was not attractive, he somehow puts the thought of the warfarin as "really quite frightening" and goes on to make completely wrong (sadly common) misrepresentations on how it will "shorten your life". This is of course more of an appeal to emotion (again) and not supported by many facts.
one more hammer for the anticoagulation therapy at the end (clearly he has a horror of that). He adds that "if you speak to people who are on long term warfarin it is a serious compromise to your quality of life". Where he gets the "it inevitably foreshortens your life" from I'm just not sure.
Strangely we just don't find that in our group. The majority here who are on long term warfarin do not say its a serious compromise ... wonder who he spoke to?
So, all in all very interesting but quite a bit beneath the levels I have come to expect in TED talks.
Ultimately I think its a great tool to add to the repertoire of surgery and I hope it goes somewhere (despite the obvious conservative barriers). For those who need aortic graft and don't need a valve replacement I really do hope it gets mainstream.
