Error: could not connect to database server. Please contact the system administrator.viagra 300mg Antation. This is a procedure typically reserved for younger patients, who would not want to be on life-long anticoagulation with coumadin, and whose life expectancy should exceed that of a tissue (animal) valve. We have performed this surgery at valley in patients aged up to their young 70’s, depending on their overall risk profile for surgery. The tabav program at valley hospital has the largest active experience with this important procedure in our area, outside of new york city. For more on why aortic valve preservation may be preferable to replacement, link to the aortic valve repair (avr) page. For more information, please call, 201-447-8418 or e-mail us at webinfo@valleyhealth. Com certain patients with root aneurysms may not be candidates for the david procedure. If the aortic valve itself is not healthy, it should not be preserved or re-implanted. While even a severely leaking valve is not a contraindication, calcification of the valve often is. Some imaging studies, especially echo, might suggest that a particular valve is calcified when it is not. The misinterpretation might be due to valve leaflet thickening, particularly common in bicuspid aortic valves (bavs). When the valve is not suitable for re-implantation, either based on patient age and co-morbidities, or due to anatomic features, the valve is removed, and a traditional aortic root replacement is performed. This can be accomplished in a variety of ways, but all methods will have some things in common: the aortic root aneurysm is removed from the body, the origins of the two main coronary arteries are sewn to the replacement graft, and a new valve is implanted. The valve replacement may comprise pig, cow, or horse tissue, or a mechanical (metal) valve. In general, we favor tissue valves, with a preference for a strategy that avoids the need for life-long anticoagulation with coumadin. Our typical approach to the biological bentall procedure is to use a commercially available 'full' porcine (pig) aortic root replacement. In this arrangement, the entire pig aortic root (including the valve, aorta and coronary artery origins) has been removed from the animal and processed as an off-the-shelf product. The main advantage of this approach is that the valve will continue to experience 'normal' shear stresses after implantation, since the dimensions of the aortic root tissue that 'live' with the valve are physiologic, and perfectly matched to the valve. This means less wear and tear over the years, and better long term durability. viagra online cheap viagra online buy viagra online viagra without a doctor prescription buy viagra viagra for sale cheap viagra uk next day delivery buy viagra online viagra online cheap viagra In additi.