[HSF] LA Plication Reduction Plasty

Wed Nov 22 19:46:47 EST 2006

Nice drawing Prasanna .... 
I've not connected the inter PV placation to the atriotomy line ... 
- do you do that as a standard technique ???? 
- also the roof plication line .... is it a standard in all your cases ???
.... 
- do you perform all the 3 plications in all cases ?? ....
- also ... do you perform peri-annular plication in cases of repair ???
- what about LAA .... ?? 
- I guess you do that placation solely through a conventional left atriotomy
... only ??? 

NFA

> -----Original Message-----
> From: openheart-l-bounces at lists.hsforum.com [mailto:openheart-l-
> bounces at lists.hsforum.com] On Behalf Of prasannasimha
> Sent: Wednesday, November 22, 2006 9:39 AM
> To: OpenHeart-L at lists.hsforum.com
> Subject: Re: [HSF] LA Plication Reduction Plasty
> 
> These are the lines in a poorly made diagram. My scanner is giving
> problems. Last few days has been an electronic nightmare !! Hope you get
> the idea with the figure
> Prasanna
> 
> Tea Acuff wrote:
> > Can you draw a picture? It is hard to see what was where?
> > tea
> >
> >
> > ----- Original Message ----
> > From: prasannasimha <prasannasimha at gmail.com>
> > To: OpenHeart-L at lists.hsforum.com
> > Sent: Tuesday, November 21, 2006 8:45:56 PM
> > Subject: Re: [HSF] LA Plication Reduction Plasty
> >
> >
> > Nasser , this is an old picture of a case which required a replacement
> > and excision of the LA was also done. I did not excise the LA in the
> > case that was discussed but just plicate-imbricated it. I also had
> > conserved his native valve.
> > Prasanna
> > psimha wrote:
> >
> >> I use the technique described by Kawazoe which involves interpulmonary
> >> vein plication, plication between the pulmonary veins and the mitral
> >> annulus and at the roof of the LA. I usually do not do this unless the
> >> LA is really huge and papery thin or with an associated cardiovocal
> >> syndrome as I have seen that these LA's can and will reduce in size
> >> with establishment of sinus rhythm and correction of the mitral
> >> disease.. I also at times resected a patch of LA from the inferior end
> >> of the atriotomy  extending to the area between the pulmonary veins
> >> but after the case with the papery thin LA which bled and was
> >> difficult to get hemostasis, I am plicating extensively rather than
> >> excising in such LA's - easier and less of a bother. Plication
> >> involves both plication and inverting so the exposed internal surface
> >> is only one suture line. I think I sent a set of pictures once. In
> >> that I had also excised the LA.
> >> Some people use a method described by Batista - explant the heart ,
> >> trim the LA and auto transplant it back. I am wary of doing such an
> >> extensive procedure when an easier alternative exists. People who have
> >> done it say that replacement is very easy though I have not heard
> >> about a repair being done and tested. On the other hand - how
> >> difficult is it to expose the mitral valve in a giant LA - the Giant
> >> LA allows the mitral valve to be easily exposed any way.
> >> Prasanna
> >> Nasser F. Abou'Seada wrote:
> >>
> >>> Dear Prasanna ...
> >>> would you elaborate more on your technique doing left atrial
"placation
> >>> reduction plasty" ..?
> >>>
> >>> NFA
> >>>
> >>>
> >>>
> >>>> -----Original Message-----
> >>>> From: openheart-l-bounces at lists.hsforum.com [mailto:openheart-l-
> >>>> bounces at lists.hsforum.com] On Behalf Of prasannasimha
> >>>> Sent: Monday, November 20, 2006 12:57 PM
> >>>> To: Michael Kuiper
> >>>> Cc: OpenHeart-L at lists.hsforum.com; ccm
> >>>> Subject: [HSF] Re: ccmlquiz20/11/2006
> >>>>
> >>>> That was a giant LA in a patient with MR with  Cardiovocal syndrome
> >>>> (Ortner's Syndrome)
> >>>> This is his X Ray immediately post op after an MVR + Electocautery
Maze
> >>>> + Kawazoe procedure (Left atrial plication reduction plasty ) done on
> >>>> the 15th.
> >>>>
> >>>> Prasanna
> >>>>
> >>>> Michael Kuiper wrote:
> >>>>
> >>>>
> >>>>> not immediately.... it may be the heart...
> >>>>>
> >>>>> ----- Original Message ----- From: "prasannasimha"
> >>>>> <prasannasimha at gmail.com>
> >>>>> To: <OpenHeart-L at lists.hsforum.com>; "ccm" <ccm-l at ccm-l.org>
> >>>>> Sent: Monday, November 20, 2006 6:43 PM
> >>>>> Subject: ccmlquiz20/11/2006
> >>>>>
> >>>>>
> >>>>>
> >>>>>
> >>>>>> Will you put a chest tube in this patient ?
> >>>>>>
> >>>>>> Prasanna
> >>>>>>
> >>>>>>
> >>>>>>
> >>>>>>
> >>>>>> __________ NOD32 1873 (20061120) Informatie __________
> >>>>>>
> >>>>>> Dit bericht is gecontroleerd door het NOD32 Antivirus Systeem.
> >>>>>> http://www.nod32.nl
> >>>>>>
> >>>>>>
> >>>>>>
> >>>>>>
> >>> _______________________________________________
> >>> OpenHeart-L mailing list
> >>>
> >>> Send postings to:
> >>>  OpenHeart-L at lists.hsforum.com
> >>>
> >>> To UNSUBSCRIBE, to CHANGE email address, or to view archives:
> >>> http://mmp.cjp.com/mailman/listinfo/openheart-l
> >>>
> >>> All messages transmitted by the OpenHeart-L are subject to the
> >>> policies and disclaimers posted at:
> >>> http://www.hsforum.com/listdisclaim
> >>> -----------------------------------------
> >>>
> >>>
> >>>
> >>>
> >> _______________________________________________
> >> OpenHeart-L mailing list
> >>
> >> Send postings to:
> >> OpenHeart-L at lists.hsforum.com
> >>
> >> To UNSUBSCRIBE, to CHANGE email address, or to view archives:
> >> http://mmp.cjp.com/mailman/listinfo/openheart-l
> >>
> >> All messages transmitted by the OpenHeart-L are subject to the
> >> policies and disclaimers posted at:
> >> http://www.hsforum.com/listdisclaim
> >> -----------------------------------------
> >>
> >>
> >>
> > _______________________________________________
> > OpenHeart-L mailing list
> >
> > Send postings to:
> > OpenHeart-L at lists.hsforum.com
> >
> > To UNSUBSCRIBE, to CHANGE email address, or to view archives:
> > http://mmp.cjp.com/mailman/listinfo/openheart-l
> >
> > All messages transmitted by the OpenHeart-L are subject to the policies
and
> > disclaimers posted at:
> > http://www.hsforum.com/listdisclaim
> > -----------------------------------------
> > _______________________________________________
> > OpenHeart-L mailing list
> >
> > Send postings to:
> >  OpenHeart-L at lists.hsforum.com
> >
> > To UNSUBSCRIBE, to CHANGE email address, or to view archives:
> > http://mmp.cjp.com/mailman/listinfo/openheart-l
> >
> > All messages transmitted by the OpenHeart-L are subject to the policies
and
> > disclaimers posted at:
> > http://www.hsforum.com/listdisclaim
> > -----------------------------------------
> >
> >