[HSF] aortic regurg and severe LV dysfunction

[Ani Anyanwu]

Do you have access to transplantation? If so you should first evaluate him for transplant.

If no transplant surgery, and you have access to VADs, then you can offer conventionaly surgery with VAD back-up as high risk of postcardiotomy failure.  
If no transplant or VAD service, probably best to refer patient elsewhere if possible or undertake procedure accepting you may not be giving this young patint the greatest possible chance of survival.

I had a similar case I did 2 weeks ago EF 8% with mod AI, severe MR and TR dilated cardiomyopathy. He was not transplant candidate so did triple valve - he did okay and is home now. EF improved marginally (15%) but need to wait and see if reverse remodelling but am skeptical as LVEDD was 9cm.

Ani
  ----- Original Message ----- 
  From: erdinç naseri<mailto:enaseri at hotmail.com.tr> 
  To: OpenHeart-L at lists.hsforum.com<mailto:OpenHeart-L at lists.hsforum.com> 
  Sent: Thursday, April 26, 2007 11:01 PM
  Subject: [HSF] aortic regurg and severe LV dysfunction




  Dear members opinion is requested regarding the following case:
  37 y/o male admitted with dyspnea.H/o AI (TTE 5 months ago and toldto repeat 
  6 months later)
  TTE:Mitral regur ++,Aortic regurg ++;Aortic root 4.8 cm,LVEDD 7.2 cm,EF 15%
  Aorto graphy:Aortic regurg +++,CAG: nl
  No lab and clinical evidence of myocarditis or any primary myocardial 
  disease which can explain the  acute deterioration of the LV fX.
  A cardiologist in another center classified him as inoperable
  erdinc


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