Anticoagulants: A Perspective of Medical Devices Inventor: Carl Goosen
Author: Carl Goosen
Anticoagulants are the reason the bulk of prosthetic heart valves are no longer acceptable, and the catheter delivery has taken over. I am amazed how this miracle has taken over, since even the 24 hour survival rate should not be tolerated, apart from longer term might not be acceptable. The problem with all the popular valves is caused by two factors, viz., turbulence and shear forces.
Turbulence takes place while cusp mechanisms act in the highest flow area, This is present in ALL the “normal” prosthetic valves, EXCEPT MINE. My poppet moves above the seat into a slower flow area where turbulence causes “happy” vortices, which are present in normal hearts. Ajit Yoganathan, considered to be the”guru” of all the studies in this matter suggests that the areas below and above the high speed flow section are safe from damage for 5 mm and on. When my valves are open their poppets are in the safe zone and the aortic poppet’s streamline assures no disturbance. Turbulence causes defribination causes clotting which may cause emboli.
The hinge mechanisms that are used in most “regular” valves must allow free movement so the small clearance leads to shear forces, possibly hemolysing some blood.
Although there is no need for anticoagulants inmy prostheses, the FDA mandate does not permit not using anticoagulants. Even if they allowed it the doctors would take as long as when they would not give up phlebotomy. ( They still practice it in the Middle East)
By the way, there is no validity in the concept of accelerated time studies. It is not possible to divorce force from speed. A tenfold increase in speed equals an eighty-fold increase in force,
Before the FDA mandated the use of anticoagulants we had a series of patients with my aortic valve without anticoagulants. The longest one was for 13 years and he became the president of a corporation.After I left Cape Town the cardiologist fooled around with the concept and induced embolism which did not occur in the patients not on anticoagulants
Carl Goosen.
Leave a Reply