[HSF] RE: MVR with a difference

[erdinç naseri]

We see a lot of rheumatic mitrals , pure MS or Ms+MR.They mostly come to the operation late in their lives with valvular and subvalvular calcification and fibrosis unsuitable for repair. Our median valve size is 27 and to a lesser degree 29 but not 25.( mostly female and average BW around 65 kg)
erdinc> From: anianyanwu at hotmail.com> To: openheart-l at lists.hsforum.com> Subject: RE: [HSF] RE: MVR with a difference> Date: Tue, 14 Aug 2007 15:13:26 +0000> > Would anybody seriously give Ahmed flak about placing a 25mm Mitral prosthesis? In our institution, 25mm is actually the median size of our implanted mitral prostheses (it is unusual to have patients that need bigger sized valves as these are generally reparable - most that cannot be repaired are small rheumatic valves where it is difficult to get anything bigger than a 25 or 27). If a surgeon is frequently implanting large mitral prosthesis (29mm or more) then he needs to examine his practice as I suspect most such valves could have been repaired.> > Ani> > > > > Date: Tue, 14 Aug 2007 18:29:12 +0530> From: prasannasimha at gmail.com> To: OpenHeart-L at lists.hsforum.com> Subject: Re: [HSF] RE: MVR with a difference> CC: > > That tiny old marm isn't going to take part in the Olympics so don't > worry !! No flak only congrats.> Prasanna> Michael Firstenberg wrote:> > No frowns whenever you operate on an 85 year old and you can discharge her> > home.> >> > -michael> >> >> > On 8/14/07, A <alsadd at ksu.edu.sa> wrote:> > > >> I have to give you feed back on this patient. She was operated last week> >> and> >> we discussed the choice of valves with her family they opted for a tissue> >> valve. She received a size 25 Carpentier Edwards tissue valve. I know some> >> of you would frown up on that and I am expecting a lot of flak. By the way> >> she is about ready to be discharged home> >>> >> Ahmed> >>> >> -----Original Message-----> >> From: openheart-l-bounces at lists.hsforum.com> >> [mailto:openheart-l-bounces at lists.hsforum.com] On Behalf Of Dr. Roberto> >> Battellini> >> Sent: Wednesday, August 08, 2007 6:24 AM> >> To: OpenHeart-L at lists.hsforum.com> >> Subject: AW: [HSF] RE: MVR with a difference> >>> >> I had to use a Nr 25 aortic valve 2 times in a mitral position. If the> >> patient is like yours, no problem.> >> If your plastic fails, do not decalcify completely the annulus...or you> >> call> >> the devil. Better partially as needed.> >> Roberto> >>> >> -----Ursprüngliche Nachricht-----> >> Von: openheart-l-bounces at lists.hsforum.com> >> [mailto:openheart-l-bounces at lists.hsforum.com] Im Auftrag von A> >> Gesendet: Mittwoch, 8. August 2007 23:09> >> An: OpenHeart-L at lists.hsforum.com> >> Betreff: [HSF] RE: MVR with a difference> >>> >>> >>> >>> >>> >> _____> >>> >> From: A [mailto:alsadd at ksu.edu.sa]> >> Sent: Wednesday, August 08, 2007 3:08 PM> >> To: 'OpenHeart-L at lists.hsforum.com'> >> Subject: MVR with a difference> >>> >>> >>> >> Dear forum members:> >>> >> A fragile 85-year old female weighs 41Kg has severe MS. Echo reveals heavy> >> calcification of the valve MVA is < 0.75> >>> >> Coronaries are clean no other co-morbid conditions. Planning surgery with> >> the hope of repair but the cardiologists are warning me that the valve is> >> densely calcified LA rather small. I have a feeling that a size 27 would> >> be> >> difficult to use in her case.> >>> >>> >>> >> In the event of failure of repair and we had to replace, given her> >> fragility, weight and the small LA what do you recommend tissue or a> >> mechanical valve ? The other question would any one of the members use a> >> size 25 in the mitral?> >>> >> In either categories of the prosthetic valves.> >>> >> Thank you for your opinion.> >>> >>> >>> >> My apologies I forgot to sign my name I am re-sending it. Please excuse> >> the> >> error> >>> >>> >>> >> Ahmed> >>> >> _______________________________________________> >> 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> > -----------------------------------------> >> >> > > > _______________________________________________> 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> -----------------------------------------> _________________________________________________________________> The next generation of MSN Hotmail has arrived - Windows Live Hotmail> http://www.newhotmail.co.uk_______________________________________________> 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> -----------------------------------------