[HSF] Ventriculo annular continuity in Rheumatic patients

[Nasser F. Abou'Seada]

Dear Bob 
I totally concur with your point of view ..... total anecdotal experience
..... we used to replace many of these stenosed valves with small size
ventricles, with removal of the valve, chordae in one piece" I used to have
the tips of the papillary muscles for ventricular biopsy". still ... almost
of these rheumatic patients are doing very well with very minimal
deterioration in Ventricular functions over time ...... extending to the mid
80s ........ 

NFA

> From: Rwmfglycar at aol.com
> One last point: If  he had his annular papillary connection excised in
1970
> and has got this far he has already experienced such deterioration of
> function that maneuver may have induced. Although I am a great believer in
> preservation of the annular papillary connection I have to tell you that
rheumatic
> stenosis patients who have had the whole valve removed without
reestablishing
> the connection can have very little evident deterioration. I  learned this
from
> reviewing my reoperative mitral patients from 1964 to 2000.  The ejection
> fractions of two groups of stenosis patients, one with  preservation and
one
> without had the same ventricular function at the second or  later
operations.
> Yours
> Bob