Erschienen in:
01.01.2020 | EDITORIAL
Disseminating valve repairs—a clarion call
verfasst von:
Om Prakash Yadava
Erschienen in:
Indian Journal of Thoracic and Cardiovascular Surgery
|
Sonderheft 1/2020
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Excerpt
More ink than blood has been spilt in eulogising the advantages of valve repair and that it should be the default procedure, and replacement of the valves should only be done by design. Yet, reparative surgery of valve remains a laggard, more so in the developing world. Partly, it may be due to the underlying substrate of rheumatic pathology in the developing world as against the more conducive degenerative variety in the developed world, but in no smaller measure, this is attributable to reticence on the part of the surgeons to take to repairs. Even the techniques for repair are more suited for the garden variety degenerative and functional pathologies, rather than the rheumatic origin mitral regurgitation seen in developing world. Even in experienced centres, the latter is technically more demanding and the results not quite as salutary as for the former variety. Inadequate training, non-availability of intra-operative transesophageal echocardiography (TEE) universally, non supportive administration of the hospital, and the fear of failure and need for a repeat surgery, specially in poor nations, where cost becomes a major determining factor too, play an important role in making matters worse. …
