From prasannasimha at gmail.com Sat Dec 1 11:12:38 2007 From: prasannasimha at gmail.com (Prasanna Simha M) Date: Sat Dec 1 05:13:08 2007 Subject: [HSF] milrinone In-Reply-To: <774864.73118.qm@web63014.mail.re1.yahoo.com> References: <774864.73118.qm@web63014.mail.re1.yahoo.com> Message-ID: <89c4ed2d0712010212t4fa3d60eva7dc740b81650c8a@mail.gmail.com> Yes, works well in patients with dysfunctional RV's and stiff LV's. I use them in patients with severe PH, RV dysfunction and tetrology patients. They reduce inotropic usage and ICU time. Prasanna On 11/30/07, james le wrote: > > Is there any evidence of milrinone usage improving the out comes > following cardiac surgery? > > [I work in public hospital where there is some on going discussion about > its cost effectiveness] > > > --------------------------------- > Get easy, one-click access to your favorites. Make Yahoo! your homepage. > _______________________________________________ > OpenHeart-L mailing list > > Send postings to: > OpenHeart-L@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 > ----------------------------------------- > -- Prasanna Simha M From benjamin.bidstrup at bigpond.com Sat Dec 1 21:39:30 2007 From: benjamin.bidstrup at bigpond.com (Ben Bidstrup) Date: Sat Dec 1 06:40:20 2007 Subject: [HSF] Ahh, the Holiday Transfer. Would anyone do anything different? In-Reply-To: References: Message-ID: Roger Mee gave a talk on this very subject at the Asian Association Meeting in Bali (immediately preceding the World Climate Conference). It is far more than just a few surgeons, but a state of mind starting at the top. Applicable to adults surgery as well. >that leads to an important question : what are the variables and parameters >that determine the success of a certain surgical program ... let it be a >paediatric and neonatal cardiac Surgical program at a certain area - >Country- ........... is it just the Surgical Competency to perform a >certain set of procedures ?? .... I suppose it is enough then to have some >surgeons trained at the best centres in the world and return them back >"home" to perform such "Procedures" in any case anatomically diagnosed as a >certain Syndrome .... !!!! ......... is raising the surgical standards in a >certain milieu just limited to the ability to perform a certain technique >???? ... ani ? .. your input ? .. > >On Nov 30, 2007 6:02 AM, wrote: > >> Bill, >> Not to sound corny, but what you are doing really represents America at >> its best. I'm proud that guys like you can go out to these developing >> areas >> and help raise the surgical standards. Keep on keeping on. >> >> Hal >> >> >> >> **************************************Check out AOL's list of 2007's >> hottest >> products. >> (http://money.aol.com/special/hot-products-2007?NCID=aoltop00030000000001) >> _______________________________________________ >> OpenHeart-L mailing list >> >> Send postings to: >> OpenHeart-L@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@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 >----------------------------------------- -- Ben Bidstrup FRACS FRCSEd FEBCTS Consultant Cardiothoracic Surgeon From msfirst at gmail.com Sat Dec 1 07:26:12 2007 From: msfirst at gmail.com (Michael Firstenberg) Date: Sat Dec 1 07:26:41 2007 Subject: [HSF] Ahh, the Holiday Transfer. Would anyone do anything different? In-Reply-To: References: Message-ID: Roger is a very smart and insightful guy - what did he have to say? Too bad he retired (and that is another story)..... In response to Ani - I often wonder what happens to these children in 3rd world countries who acutely get the best that modern medicine and surgery has to offer - and then return home. I guess (assume?) from a "tea"leologic standpoint that they must be better off than not having their anatomy fixed at all? Is that any different than many of the things that we do here in U.S. when post discharge the patients do not have the resources to pay for follow-up/medications/etc. It is not uncommon for us to ring up huge bills (and I mean HUGE) in patients who have absolutely no way of paying (which often the hospital writes off) but then they cant pay for the tons of medications/test/etc that they need down the road. Prasanna keeps talking about sending people home with tissue valves who can not afford Coumadin...... this is a common problem around the world....I guess we just do what we can to try and fix the problems in a reasonable fashion. -michael On 12/1/07, Ben Bidstrup wrote: > > Roger Mee gave a talk on this very subject at the Asian Association > Meeting in Bali (immediately preceding the World Climate Conference). > It is far more than just a few surgeons, but a state of mind starting > at the top. > > Applicable to adults surgery as well. > > >that leads to an important question : what are the variables and > parameters > >that determine the success of a certain surgical program ... let it be a > >paediatric and neonatal cardiac Surgical program at a certain area - > >Country- ........... is it just the Surgical Competency to perform a > >certain set of procedures ?? .... I suppose it is enough then to have > some > >surgeons trained at the best centres in the world and return them back > >"home" to perform such "Procedures" in any case anatomically diagnosed as > a > >certain Syndrome .... !!!! ......... is raising the surgical standards in > a > >certain milieu just limited to the ability to perform a certain technique > >???? ... ani ? .. your input ? .. > > > >On Nov 30, 2007 6:02 AM, wrote: > > > >> Bill, > >> Not to sound corny, but what you are doing really represents > America at > >> its best. I'm proud that guys like you can go out to these developing > >> areas > >> and help raise the surgical standards. Keep on keeping on. > >> > >> Hal > >> > >> > >> > >> **************************************Check out AOL's list of 2007's > >> hottest > >> products. > >> ( > http://money.aol.com/special/hot-products-2007?NCID=aoltop00030000000001) > >> _______________________________________________ > >> OpenHeart-L mailing list > >> > >> Send postings to: > >> OpenHeart-L@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@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 > >----------------------------------------- > > > -- > Ben Bidstrup FRACS FRCSEd FEBCTS > Consultant Cardiothoracic Surgeon > _______________________________________________ > OpenHeart-L mailing list > > Send postings to: > OpenHeart-L@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 > ----------------------------------------- > From battr at medizin.uni-leipzig.de Sat Dec 1 13:42:53 2007 From: battr at medizin.uni-leipzig.de (Dr. Roberto Battellini) Date: Sat Dec 1 07:34:47 2007 Subject: AW: [HSF] aortic cusp mass In-Reply-To: References: <184250.84257.qm@web81610.mail.mud.yahoo.com> Message-ID: <000001c83417$b25869d0$b3160a06@HZLPC0679> Ani, The same happens in Germany. Our case, 71 year old man had repeated syncopes. Both TTE and TEE showed the mass, with the tendency to prolapse into the left coronary ostium. The tumor was resected dissecting it from the valve. For the ones interested, our resident Thorsten Bossert published the case in J Heart Valve Dis Vol 9 Nr. 6 November 2000, there is plenty of bibliography. Roberto -----Urspr?ngliche Nachricht----- Von: openheart-l-bounces@lists.hsforum.com [mailto:openheart-l-bounces@lists.hsforum.com] Im Auftrag von Ani Anyanwu Gesendet: Freitag, 30. November 2007 13:57 An: openheart-l@lists.hsforum.com Betreff: RE: [HSF] aortic cusp mass What business did an asymptomatic 82 year old have going near an echocardiogram machine? Only in America I suppose. The poor sleeping dog has probably been asleep for years if not decades and now is awake and has woken up too all those around this poor lady. Another reminder to us not to run tests in asymptomatic patients except one is ready to deal with whatever one finds. Ani > Date: Thu, 29 Nov 2007 21:23:08 -0800> From: tacuff@swbell.net> To: OpenHeart-L@lists.hsforum.com> CC: > Subject: [HSF] aortic cusp mass> > I have an 82 year old woman asymptomatic with a 2cm smooth polypoid mass based on a tricuspid leaflet of the aortic valve. My partner recently did an resection for a fibroelastoma of the same which there are a few reported cases. Anyone seen this or a complication of this? It does not look or move like a vegetation.> > tea> _______________________________________________> OpenHeart-L mailing list> > Send postings to:> OpenHeart-L@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> ----------------------------------------- _________________________________________________________________ Telly addicts unite! http://www.searchgamesbox.com/tvtown.shtml__________________________________ _____________ OpenHeart-L mailing list Send postings to: OpenHeart-L@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 ----------------------------------------- From prasannasimha at gmail.com Sat Dec 1 20:22:07 2007 From: prasannasimha at gmail.com (Prasanna Simha M) Date: Sat Dec 1 14:28:28 2007 Subject: [HSF] aortic cusp mass In-Reply-To: <160542.37800.qm@web81614.mail.mud.yahoo.com> References: <160542.37800.qm@web81614.mail.mud.yahoo.com> Message-ID: <89c4ed2d0712011122tf54163do2418dcdc6ecfb015@mail.gmail.com> Tea, papillary fibroelastoma lookslikethe fronds of a sea anemone. I have seen 3 , 2 on the aortic valve and one on the mitral vavle . All presented with stroke. Prasanna On Nov 30, 2007 6:21 AM, Tea Acuff wrote: > I have an 82 year old woman asymptomatic with a 2cm smooth polypoid mass > based on tricuspid leaflet of the aortic valve. My partner recently did an > resection for a fibroelastoma of the same which only has a few reported > cases. Anyone seen this or a complication of this? It does not look or move > like a vegetation. > > tea > _______________________________________________ > OpenHeart-L mailing list > > Send postings to: > OpenHeart-L@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 > ----------------------------------------- > -- Prasanna Simha M From prasannasimha at gmail.com Sat Dec 1 20:27:00 2007 From: prasannasimha at gmail.com (Prasanna Simha M) Date: Sat Dec 1 14:42:18 2007 Subject: [HSF] IVC Mass In-Reply-To: <20071130084454.V5U5R.34967.root@fepweb02> References: <20071130084454.V5U5R.34967.root@fepweb02> Message-ID: <89c4ed2d0712011127s592cb7f6l24a287329332c666@mail.gmail.com> Kidneys ? Prasanna from Leipzig !! On Nov 30, 2007 2:44 PM, wrote: > Normal pelvic CT scan > > ---- Hgrmd@aol.com wrote: > > Ed, > > How's her uterus? > > > > Hal > > > > > > > > **************************************Check out AOL's list of 2007's > hottest > > products. > > ( > http://money.aol.com/special/hot-products-2007?NCID=aoltop00030000000001) > > _______________________________________________ > > OpenHeart-L mailing list > > > > Send postings to: > > OpenHeart-L@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@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 > ----------------------------------------- > -- Prasanna Simha M From ebender001 at charter.net Sat Dec 1 12:29:40 2007 From: ebender001 at charter.net (ebender001@charter.net) Date: Sat Dec 1 15:30:13 2007 Subject: [HSF] IVC Mass In-Reply-To: <89c4ed2d0712011127s592cb7f6l24a287329332c666@mail.gmail.com> Message-ID: <20071201152940.UAOA8.90371.root@fepweb16> No kidney abnormalities on CT or in urine. ---- Prasanna Simha M wrote: > Kidneys ? > Prasanna from Leipzig !! > > On Nov 30, 2007 2:44 PM, wrote: > > > Normal pelvic CT scan > > > > ---- Hgrmd@aol.com wrote: > > > Ed, > > > How's her uterus? > > > > > > Hal > > > > > > > > > > > > **************************************Check out AOL's list of 2007's > > hottest > > > products. > > > ( > > http://money.aol.com/special/hot-products-2007?NCID=aoltop00030000000001) > > > _______________________________________________ > > > OpenHeart-L mailing list > > > > > > Send postings to: > > > OpenHeart-L@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@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 > > ----------------------------------------- > > > > > > -- > Prasanna Simha M > _______________________________________________ > OpenHeart-L mailing list > > Send postings to: > OpenHeart-L@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 > ----------------------------------------- From ebender001 at charter.net Sat Dec 1 12:31:57 2007 From: ebender001 at charter.net (ebender001@charter.net) Date: Sat Dec 1 15:32:23 2007 Subject: [HSF] IVC Mass In-Reply-To: <89c4ed2d0712011127s592cb7f6l24a287329332c666@mail.gmail.com> Message-ID: <20071201153157.SALE5.90444.root@fepweb16> Prasanna: I just saw you were writing from Leipzig! Please drink a beer and have some saurbratten (sp?) for me. Her kidneys are normal. Ed Bender, MD ---- Prasanna Simha M wrote: > Kidneys ? > Prasanna from Leipzig !! > > On Nov 30, 2007 2:44 PM, wrote: > > > Normal pelvic CT scan > > > > ---- Hgrmd@aol.com wrote: > > > Ed, > > > How's her uterus? > > > > > > Hal > > > > > > > > > > > > **************************************Check out AOL's list of 2007's > > hottest > > > products. > > > ( > > http://money.aol.com/special/hot-products-2007?NCID=aoltop00030000000001) > > > _______________________________________________ > > > OpenHeart-L mailing list > > > > > > Send postings to: > > > OpenHeart-L@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@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 > > ----------------------------------------- > > > > > > -- > Prasanna Simha M > _______________________________________________ > OpenHeart-L mailing list > > Send postings to: > OpenHeart-L@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 > ----------------------------------------- From battr at medizin.uni-leipzig.de Sat Dec 1 22:28:36 2007 From: battr at medizin.uni-leipzig.de (Dr. Roberto Battellini) Date: Sat Dec 1 16:20:18 2007 Subject: AW: [HSF] IVC Mass-Prasanna and Sauerbraten-for Ed (OT) In-Reply-To: <20071201153157.SALE5.90444.root@fepweb16> References: <89c4ed2d0712011127s592cb7f6l24a287329332c666@mail.gmail.com> <20071201153157.SALE5.90444.root@fepweb16> Message-ID: <000701c83461$222e7080$b3160a06@HZLPC0679> Ed, He can not eat Sauerbraten because he is almost dead after many hours of flight, train, tramway, bus, etc to arrive here. I am on duty, and cannot carry him at home...let see tomorrow. May be he is more dead because of the problems he had to fight to get the German Visa. He got it. BTW, may be 2 months ago I operated a mixoma arising from the inferior vena cava near the right atrium, the preop diagnosis was thrombus in a pacemaker lead. When I wanted to take it with forceps I felt a resistance and it was a root, inserted in the vena cava. Hystology showed mixoma. Roberto -----Urspr?ngliche Nachricht----- Von: openheart-l-bounces@lists.hsforum.com [mailto:openheart-l-bounces@lists.hsforum.com] Im Auftrag von ebender001@charter.net Gesendet: Samstag, 1. Dezember 2007 21:32 An: OpenHeart-L@lists.hsforum.com Betreff: Re: [HSF] IVC Mass Prasanna: I just saw you were writing from Leipzig! Please drink a beer and have some saurbratten (sp?) for me. Her kidneys are normal. Ed Bender, MD ---- Prasanna Simha M wrote: > Kidneys ? > Prasanna from Leipzig !! > > On Nov 30, 2007 2:44 PM, wrote: > > > Normal pelvic CT scan > > > > ---- Hgrmd@aol.com wrote: > > > Ed, > > > How's her uterus? > > > > > > Hal > > > > > > > > > > > > **************************************Check out AOL's list of 2007's > > hottest > > > products. > > > ( > > http://money.aol.com/special/hot-products-2007?NCID=aoltop00030000000001) > > > _______________________________________________ > > > OpenHeart-L mailing list > > > > > > Send postings to: > > > OpenHeart-L@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@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 > > ----------------------------------------- > > > > > > -- > Prasanna Simha M > _______________________________________________ > OpenHeart-L mailing list > > Send postings to: > OpenHeart-L@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@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 ----------------------------------------- From gabiford at hotmail.com Sat Dec 1 22:40:30 2007 From: gabiford at hotmail.com (gabi ford) Date: Sat Dec 1 17:40:59 2007 Subject: [HSF] -Prasanna and Sauerbraten-(OT) In-Reply-To: <000701c83461$222e7080$b3160a06@HZLPC0679> References: <89c4ed2d0712011127s592cb7f6l24a287329332c666@mail.gmail.com> <20071201153157.SALE5.90444.root@fepweb16> <000701c83461$222e7080$b3160a06@HZLPC0679> Message-ID: From: battr@medizin.uni-leipzig.de > He can not eat Sauerbraten because he is almost dead after many hours of > flight, train, tramway, bus, etc to arrive here. I am on duty, and cannot > carry him at home...let see tomorrow. May be he is more dead because of the > problems he had to fight to get the German Visa. He got it. Hello Prasanna and Robert, Don't make it sound as if the German authorities have complicated Transnationalvorschriftsbestimmungsregulierungen or somethin'!!!!!! ;) Please allow me to indulge in a joke regarding stereotypes of European folks: HEAVEN IS - where the French are the cooks - where the Italians are the lovers - where the Germans are the mechanics - where the Swiss run the hotels - where the British are the police HELL IS - where the Swiss are the lovers - where the British are the cooks - where the Italians run the hotels - where the French are the mechanics - where the Germans are the police Ciao, Gabi From bbiocina at kbd.hr Sat Dec 1 23:57:36 2007 From: bbiocina at kbd.hr (bbiocina@kbd.hr) Date: Sat Dec 1 18:03:16 2007 Subject: AW: [HSF] IVC Mass-Prasanna and Sauerbraten-for Ed (OT) In-Reply-To: <000701c83461$222e7080$b3160a06@HZLPC0679> Message-ID: <9YYx8eN4.1196549856.5617110.bbiocina@kbd.hr> Well , I am glad ( and proud) to say that Croatian visa for Prasanna went much easier. I only hope that Hal won?t be stopped here at Zagreb airport tomorrow. Best to all , Bojan On 12/1/2007, "Dr. Roberto Battellini" wrote: >Ed, >He can not eat Sauerbraten because he is almost dead after many hours of >flight, train, tramway, bus, etc to arrive here. I am on duty, and cannot >carry him at home...let see tomorrow. May be he is more dead because of the >problems he had to fight to get the German Visa. He got it. > >BTW, may be 2 months ago I operated a mixoma arising from the inferior vena >cava near the right atrium, the preop diagnosis was thrombus in a pacemaker >lead. When I wanted to take it with forceps I felt a resistance and it was a >root, inserted in the vena cava. Hystology showed mixoma. >Roberto > >-----Urspr?ngliche Nachricht----- >Von: openheart-l-bounces@lists.hsforum.com >[mailto:openheart-l-bounces@lists.hsforum.com] Im Auftrag von >ebender001@charter.net >Gesendet: Samstag, 1. Dezember 2007 21:32 >An: OpenHeart-L@lists.hsforum.com >Betreff: Re: [HSF] IVC Mass > >Prasanna: >I just saw you were writing from Leipzig! Please drink a beer and have some >saurbratten (sp?) for me. > >Her kidneys are normal. > >Ed Bender, MD > >---- Prasanna Simha M wrote: >> Kidneys ? >> Prasanna from Leipzig !! >> >> On Nov 30, 2007 2:44 PM, wrote: >> >> > Normal pelvic CT scan >> > >> > ---- Hgrmd@aol.com wrote: >> > > Ed, >> > > How's her uterus? >> > > >> > > Hal >> > > >> > > >> > > >> > > **************************************Check out AOL's list of 2007's >> > hottest >> > > products. >> > > ( >> > >http://money.aol.com/special/hot-products-2007?NCID=aoltop00030000000001) >> > > _______________________________________________ >> > > OpenHeart-L mailing list >> > > >> > > Send postings to: >> > > OpenHeart-L@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@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 >> > ----------------------------------------- >> > >> >> >> >> -- >> Prasanna Simha M >> _______________________________________________ >> OpenHeart-L mailing list >> >> Send postings to: >> OpenHeart-L@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@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@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 >----------------------------------------- From hgrmd at aol.com Sat Dec 1 23:23:43 2007 From: hgrmd at aol.com (hgrmd@aol.com) Date: Sat Dec 1 18:25:19 2007 Subject: AW: [HSF] IVC Mass-Prasanna and Sauerbraten-for Ed (OT) In-Reply-To: <000701c83461$222e7080$b3160a06@HZLPC0679> References: <89c4ed2d0712011127s592cb7f6l24a287329332c666@mail.gmail.com><20071201153157.SALE5.90444.root@fepweb16><000701c83461$222e7080$b3160a06@HZLPC0679> Message-ID: <280002375-1196551429-cardhu_decombobulator_blackberry.rim.net-878386734-@bxe003.bisx.prod.on.blackberry> Roberto, I was supposed to leave today for Zagreb, Croatia to visit Bojan. Unfortunately, bad weather with a connecting flight delayed it until tomorrow. On Wednesday, I hope to see you and Prasanna in Leipzig. Hal Sent from my Verizon Wireless BlackBerry -----Original Message----- From: "Dr. Roberto Battellini" Date: Sat, 1 Dec 2007 22:28:36 To: Subject: AW: [HSF] IVC Mass-Prasanna and Sauerbraten-for Ed (OT) Ed, He can not eat Sauerbraten because he is almost dead after many hours of flight, train, tramway, bus, etc to arrive here. I am on duty, and cannot carry him at home...let see tomorrow. May be he is more dead because of the problems he had to fight to get the German Visa. He got it. BTW, may be 2 months ago I operated a mixoma arising from the inferior vena cava near the right atrium, the preop diagnosis was thrombus in a pacemaker lead. When I wanted to take it with forceps I felt a resistance and it was a root, inserted in the vena cava. Hystology showed mixoma. Roberto -----Urspr?ngliche Nachricht----- Von: openheart-l-bounces@lists.hsforum.com [mailto:openheart-l-bounces@lists.hsforum.com] Im Auftrag von ebender001@charter.net Gesendet: Samstag, 1. Dezember 2007 21:32 An: OpenHeart-L@lists.hsforum.com Betreff: Re: [HSF] IVC Mass Prasanna: I just saw you were writing from Leipzig! Please drink a beer and have some saurbratten (sp?) for me. Her kidneys are normal. Ed Bender, MD ---- Prasanna Simha M wrote: > Kidneys ? > Prasanna from Leipzig !! > > On Nov 30, 2007 2:44 PM, wrote: > > > Normal pelvic CT scan > > > > ---- Hgrmd@aol.com wrote: > > > Ed, > > > How's her uterus? > > > > > > Hal > > > > > > > > > > > > **************************************Check out AOL's list of 2007's > > hottest > > > products. > > > ( > > http://money.aol.com/special/hot-products-2007?NCID=aoltop00030000000001) > > >_______________________________________________ > > > OpenHeart-L mailing list > > > > > > Send postings to: > > > OpenHeart-L@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@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 > > ----------------------------------------- > > > > > > -- > Prasanna Simha M >_______________________________________________ > OpenHeart-L mailing list > > Send postings to: > OpenHeart-L@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@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@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 ----------------------------------------- From benjamin.bidstrup at bigpond.com Sun Dec 2 09:41:14 2007 From: benjamin.bidstrup at bigpond.com (Ben Bidstrup) Date: Sat Dec 1 18:41:59 2007 Subject: AW: [HSF] IVC Mass-Prasanna and Sauerbraten-for Ed (OT) In-Reply-To: <000701c83461$222e7080$b3160a06@HZLPC0679> References: <89c4ed2d0712011127s592cb7f6l24a287329332c666@mail.gmail.com> <20071201153157.SALE5.90444.root@fepweb16> <000701c83461$222e7080$b3160a06@HZLPC0679> Message-ID: Well, They let Fred and Max into Indonesia!! >Ed, >He can not eat Sauerbraten because he is almost dead after many hours of >flight, train, tramway, bus, etc to arrive here. I am on duty, and cannot >carry him at home...let see tomorrow. May be he is more dead because of the >problems he had to fight to get the German Visa. He got it. > >BTW, may be 2 months ago I operated a mixoma arising from the inferior vena >cava near the right atrium, the preop diagnosis was thrombus in a pacemaker >lead. When I wanted to take it with forceps I felt a resistance and it was a >root, inserted in the vena cava. Hystology showed mixoma. >Roberto > >-----Urspr?ngliche Nachricht----- >Von: openheart-l-bounces@lists.hsforum.com >[mailto:openheart-l-bounces@lists.hsforum.com] Im Auftrag von >ebender001@charter.net >Gesendet: Samstag, 1. Dezember 2007 21:32 >An: OpenHeart-L@lists.hsforum.com >Betreff: Re: [HSF] IVC Mass > >Prasanna: >I just saw you were writing from Leipzig! Please drink a beer and have some >saurbratten (sp?) for me. > >Her kidneys are normal. > >Ed Bender, MD > >---- Prasanna Simha M wrote: >> Kidneys ? >> Prasanna from Leipzig !! >> >> On Nov 30, 2007 2:44 PM, wrote: >> >> > Normal pelvic CT scan >> > >> > ---- Hgrmd@aol.com wrote: >> > > Ed, >> > > How's her uterus? >> > > >> > > Hal >> > > >> > > >> > > >> > > **************************************Check out AOL's list of 2007's >> > hottest >> > > products. >> > > ( >> > >http://money.aol.com/special/hot-products-2007?NCID=aoltop00030000000001) >> > > _______________________________________________ >> > > OpenHeart-L mailing list >> > > >> > > Send postings to: >> > > OpenHeart-L@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@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 >> > ----------------------------------------- >> > >> >> >> >> -- >> Prasanna Simha M >> _______________________________________________ >> OpenHeart-L mailing list >> >> Send postings to: >> OpenHeart-L@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@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@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 >----------------------------------------- -- Ben Bidstrup FRACS FRCSEd FEBCTS Consultant Cardiothoracic Surgeon From nfaabouseada at gmail.com Sat Dec 1 18:07:34 2007 From: nfaabouseada at gmail.com (Nasser F. Abou'Seada) Date: Sat Dec 1 19:08:05 2007 Subject: [HSF] Ahh, the Holiday Transfer. Would anyone do anything different? In-Reply-To: References: Message-ID: Dear Ben Could not agree more ......... in fact that was the answer for a higher conscious mind .... the simple one answer is that a team is certainly required .... the deeper thinking is that training of the "locals" is certainly what is needed .... all the locals .... making a local team ... not just showing some heroic procedures that could be clearly seen on a live broadcast at the internet from some distant hospital ... thinking that this may raise the surgical standards at a certain location is like improving the traffic in a certain country by observing the traffic in Ohio ... Still ........ the deepest vision to my mind is what you have started with .... a state of the mind starting at the top .... with a vision setting up the frame of thinking and allowing for the construction of a suitable plateform ... on which building on can continue ........ training the locals is certainly just one of these steps to follow ......... training a super-natural surgeon or whatever to demonstrate complex complicated procedures in an ambiguous environment .. is certainly the last that is thought off as a direct means of raising the surgical standards at a certain location ...... ... no wonder Roger Mee was the one bringing that matter to the lime light ...... his experience in Cleveland was very enriching by all means and in all aspects .... Your comment was very insightful .... as always expected ... NFA On Dec 1, 2007 5:39 AM, Ben Bidstrup wrote: > Roger Mee gave a talk on this very subject at the Asian Association > Meeting in Bali (immediately preceding the World Climate Conference). > It is far more than just a few surgeons, but a state of mind starting > at the top. > > Applicable to adults surgery as well. > > >that leads to an important question : what are the variables and > parameters > >that determine the success of a certain surgical program ... let it be a > >paediatric and neonatal cardiac Surgical program at a certain area - > >Country- ........... is it just the Surgical Competency to perform a > >certain set of procedures ?? .... I suppose it is enough then to have > some > >surgeons trained at the best centres in the world and return them back > >"home" to perform such "Procedures" in any case anatomically diagnosed as > a > >certain Syndrome .... !!!! ......... is raising the surgical standards in > a > >certain milieu just limited to the ability to perform a certain technique > >???? ... ani ? .. your input ? .. > > > >On Nov 30, 2007 6:02 AM, wrote: > > > >> Bill, > >> Not to sound corny, but what you are doing really represents America > at > >> its best. I'm proud that guys like you can go out to these developing > >> areas > >> and help raise the surgical standards. Keep on keeping on. > >> > >> Hal > >> > >> > >> > >> **************************************Check out AOL's list of 2007's > >> hottest > >> products. > >> ( > http://money.aol.com/special/hot-products-2007?NCID=aoltop00030000000001) > >> _______________________________________________ > >> OpenHeart-L mailing list > >> > >> Send postings to: > >> OpenHeart-L@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@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 > >----------------------------------------- > > > -- > Ben Bidstrup FRACS FRCSEd FEBCTS > Consultant Cardiothoracic Surgeon > _______________________________________________ > OpenHeart-L mailing list > > Send postings to: > OpenHeart-L@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 > ----------------------------------------- > From jamesle2007 at yahoo.com Sat Dec 1 18:03:52 2007 From: jamesle2007 at yahoo.com (james le) Date: Sat Dec 1 21:05:19 2007 Subject: [HSF] milrinone In-Reply-To: <89c4ed2d0712010212t4fa3d60eva7dc740b81650c8a@mail.gmail.com> Message-ID: <313108.90122.qm@web63013.mail.re1.yahoo.com> Thanks Dr Prasanna, Are there any studies which compared milrinone versus other inotropes which showed the superiority of milrinone regarding outcomes? Prasanna Simha M wrote: Yes, works well in patients with dysfunctional RV's and stiff LV's. I use them in patients with severe PH, RV dysfunction and tetrology patients. They reduce inotropic usage and ICU time. Prasanna On 11/30/07, james le wrote: > > Is there any evidence of milrinone usage improving the out comes > following cardiac surgery? > > [I work in public hospital where there is some on going discussion about > its cost effectiveness] > > > --------------------------------- > Get easy, one-click access to your favorites. Make Yahoo! your homepage. > _______________________________________________ > OpenHeart-L mailing list > > Send postings to: > OpenHeart-L@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 > ----------------------------------------- > -- Prasanna Simha M _______________________________________________ OpenHeart-L mailing list Send postings to: OpenHeart-L@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 ----------------------------------------- --------------------------------- Be a better sports nut! Let your teams follow you with Yahoo Mobile. Try it now. From prasannasimha at gmail.com Sun Dec 2 15:59:01 2007 From: prasannasimha at gmail.com (Prasanna Simha M) Date: Sun Dec 2 09:59:32 2007 Subject: [HSF] milrinone In-Reply-To: <313108.90122.qm@web63013.mail.re1.yahoo.com> References: <89c4ed2d0712010212t4fa3d60eva7dc740b81650c8a@mail.gmail.com> <313108.90122.qm@web63013.mail.re1.yahoo.com> Message-ID: <89c4ed2d0712020659s5d8adb7al6f3a7ee6a4a0202d@mail.gmail.com> There are articles and especially in the pediatric age group for eg it has been shown to be of benefit in the arterial switch and tetralogy etc. Basically I believe its best use is in patients with pulmonary hypertension and also RVdsfunction and in any condition where ventricular relaxation is impaired as it is virtually the only inotrope with lusitropic action. I would use it judiciously in these cases. Remember that itcan ccasue a fall in SVR and so adequate volume loading (best given on the pump and warn the perfusionist of a possible fall in the reservoir level -) In some cases it may be of benefit to combine it with Norepinephrine. Prasanna (in Leipzig at present) On Dec 2, 2007 3:03 AM, james le wrote: > Thanks Dr Prasanna, > > Are there any studies which compared milrinone versus other inotropes > which showed the superiority of milrinone regarding outcomes? > > Prasanna Simha M wrote: > Yes, works well in patients with dysfunctional RV's and stiff LV's. I use > them in patients with severe PH, RV dysfunction and tetrology patients. > They reduce inotropic usage and ICU time. > Prasanna > > > On 11/30/07, james le wrote: > > > > Is there any evidence of milrinone usage improving the out comes > > following cardiac surgery? > > > > [I work in public hospital where there is some on going discussion about > > its cost effectiveness] > > > > > > --------------------------------- > > Get easy, one-click access to your favorites. Make Yahoo! your homepage. > > _______________________________________________ > > OpenHeart-L mailing list > > > > Send postings to: > > OpenHeart-L@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 > > ----------------------------------------- > > > > > > -- > Prasanna Simha M > _______________________________________________ > OpenHeart-L mailing list > > Send postings to: > OpenHeart-L@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 > ----------------------------------------- > > > > --------------------------------- > Be a better sports nut! Let your teams follow you with Yahoo Mobile. Try > it now. > _______________________________________________ > OpenHeart-L mailing list > > Send postings to: > OpenHeart-L@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 > ----------------------------------------- > -- Prasanna Simha M From prasannasimha at gmail.com Sun Dec 2 16:38:19 2007 From: prasannasimha at gmail.com (Prasanna Simha M) Date: Sun Dec 2 10:38:44 2007 Subject: [HSF] IVC Mass In-Reply-To: <20071201153157.SALE5.90444.root@fepweb16> References: <89c4ed2d0712011127s592cb7f6l24a287329332c666@mail.gmail.com> <20071201153157.SALE5.90444.root@fepweb16> Message-ID: <89c4ed2d0712020738r6a1d9326wed4e0548f736a0fc@mail.gmail.com> Apart from malignancies I would also look for a prothrombotic state. I have seen IVC thrombi in patients with anticardiolipin antibodies. So a procoagulant work up woould also be in order. Some IVC webs mmay also have thrombi On Dec 1, 2007 9:31 PM, wrote: > Prasanna: > I just saw you were writing from Leipzig! Please drink a beer and have > some saurbratten (sp?) for me. > > Her kidneys are normal. > > Ed Bender, MD > > ---- Prasanna Simha M < prasannasimha@gmail.com> wrote: > > Kidneys ? > > Prasanna from Leipzig !! > > > > On Nov 30, 2007 2:44 PM, < ebender001@charter.net> wrote: > > > > > Normal pelvic CT scan > > > > > > ---- Hgrmd@aol.com wrote: > > > > Ed, > > > > How's her uterus? > > > > > > > > Hal > > > > > > > > > > > > > > > > **************************************Check out AOL's list of 2007's > > > hottest > > > > products. > > > > ( > > > > http://money.aol.com/special/hot-products-2007?NCID=aoltop00030000000001) > > > > _______________________________________________ > > > > OpenHeart-L mailing list > > > > > > > > Send postings to: > > > > OpenHeart-L@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@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 > > > ----------------------------------------- > > > > > > > > > > > -- > > Prasanna Simha M > > _______________________________________________ > > OpenHeart-L mailing list > > > > Send postings to: > > OpenHeart-L@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 > > ----------------------------------------- > > -- Prasanna Simha M From prasannasimha at gmail.com Sun Dec 2 16:55:41 2007 From: prasannasimha at gmail.com (Prasanna Simha M) Date: Sun Dec 2 10:56:18 2007 Subject: [HSF] IVC Mass In-Reply-To: <20071201153157.SALE5.90444.root@fepweb16> References: <89c4ed2d0712011127s592cb7f6l24a287329332c666@mail.gmail.com> <20071201153157.SALE5.90444.root@fepweb16> Message-ID: <89c4ed2d0712020755h77f16e9brfef7ff19e0cd87a3@mail.gmail.com> Being vegetarian and teetotaller both are out !! But I ahve eaten a fantastic variety of cheeses On Dec 1, 2007 9:31 PM, wrote: > Prasanna: > I just saw you were writing from Leipzig! Please drink a beer and have > some saurbratten (sp?) for me. > > Her kidneys are normal. > > Ed Bender, MD > > ---- Prasanna Simha M wrote: > > Kidneys ? > > Prasanna from Leipzig !! > > > > On Nov 30, 2007 2:44 PM, wrote: > > > > > Normal pelvic CT scan > > > > > > ---- Hgrmd@aol.com wrote: > > > > Ed, > > > > How's her uterus? > > > > > > > > Hal > > > > > > > > > > > > > > > > **************************************Check out AOL's list of 2007's > > > hottest > > > > products. > > > > ( > > > > http://money.aol.com/special/hot-products-2007?NCID=aoltop00030000000001) > > > > _______________________________________________ > > > > OpenHeart-L mailing list > > > > > > > > Send postings to: > > > > OpenHeart-L@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@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 > > > ----------------------------------------- > > > > > > > > > > > -- > > Prasanna Simha M > > _______________________________________________ > > OpenHeart-L mailing list > > > > Send postings to: > > OpenHeart-L@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 > > ----------------------------------------- > > -- Prasanna Simha M From hgrmd at aol.com Sun Dec 2 18:55:49 2007 From: hgrmd at aol.com (hgrmd@aol.com) Date: Sun Dec 2 13:57:00 2007 Subject: [HSF] milrinone In-Reply-To: <89c4ed2d0712020659s5d8adb7al6f3a7ee6a4a0202d@mail.gmail.com> References: <89c4ed2d0712010212t4fa3d60eva7dc740b81650c8a@mail.gmail.com><313108.90122.qm@web63013.mail.re1.yahoo.com><89c4ed2d0712020659s5d8adb7al6f3a7ee6a4a0202d@mail.gmail.com> Message-ID: <1989094414-1196621730-cardhu_decombobulator_blackberry.rim.net-1443015205-@bxe003.bisx.prod.on.blackberry> UHJhc2FubmEsDQogIEFncmVlIHdpdGggd2hhdCB5b3Ugc2F5LiAgSG93ZXZlciwgSSBwcmVmZXIg dmFzb3ByZXNzaW4gdG8gcmFpc2UgdGhlIFNWUi4gIEl0J3MgcHJvYmFibHkgbGVzcyBoYXJkIG9u IHRoZSBraWRuZXlzIGZyb20gd2hhdCBJJ3ZlIHJlYWQuICBIb3dldmVyLCB3aG8ga25vd3M/DQoN CkhhbA0KU2VudCBmcm9tIG15IFZlcml6b24gV2lyZWxlc3MgQmxhY2tCZXJyeQ0KDQotLS0tLU9y 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c3RkaXNjbGFpbQ0KLS0tLS0tLS0tLS0tLS0tLS0tLS0tLS0tLS0tLS0tLS0tLS0tLS0tLS0NCg== From tacuff at swbell.net Sun Dec 2 19:19:26 2007 From: tacuff at swbell.net (Tea Acuff) Date: Sun Dec 2 22:20:57 2007 Subject: [HSF] Ahh, the Holiday Transfer. Would anyone do anything different? Message-ID: <71147.60117.qm@web81610.mail.mud.yahoo.com> Bill, You doing some very interesting work. Among other things you are dealing with problems of medical access and teaching beyond the usual clamoring that our local program and its technical approach (and results) are best and must be embedded as the proper (and only) legitimate one. Offical legitimacy always will tend to limit access, even if it improves it for the some. Whether you feel that everyone should follow you at the moment is actually unimportant since you are providing a need that is in such need of imitation. You encourage your hosts to rethink their bias and reassess their judgements. Perhaps that is what is happening with our (the STS and USA payment) universal guidelines. Perhaps we are just encouraging those that perform poorly to reassess and reprove their standards. However, I am afraid that our relentless need to recredential, issue guidelines and pay for documenting those surrogate findings are codifying self fulfilling assessments. It seems to me, whether by design or by accident, that you are doing the opposite of what is happening in the USA. How this works from place to place probably is highly dependent on multiple local factors. Maybe I have said this before on HSF, but I attended a brief talk by Newt Gingrich at UT SW medical school in Dallas who asked us (presumbly the professors) how could we educate doctors that require 10 years to train when information is doubling in less than 6 years and accelerating. One of the emeritus professors responded that they are already in the process of solving that problem: they will soon be retesting doctors every 3 years. I almost fell out of my chair! Newt was more diplomatic in is his assessment when he pointed out that this was perhaps not really the answer to this problem. I don't know much, but I do know that the government is not likely to be truthful when they show up saying they are here to help. They might help, but that is not their main concern. The more we as physicans act the same, and particularly the more we align ourselves with the government (or insurance companies, etc) the more we need to reassess ourselves as we will be considered as politicans (or insurance companies) by our patients. I hope that I encourage a few to rethink their personal thinking bias, even if they think me wrong. It is clear that I never have the last word...even with myself. tea ----- Original Message ---- From: "ichfno@aol.com" To: OpenHeart-L@lists.hsforum.com Sent: Friday, November 30, 2007 1:39:07 AM Subject: Re: [HSF] Ahh, the Holiday Transfer. Would anyone do anything different? Tea; I don't know what will happen with the next Shone's Syndrome, but I do know this; In October 2005, we started a Stage 1 Norwood program at this institution, doing 2 Sano operations on that trip. Both kids made it to the ICU, but died 48-96 hours later in the ICU. What would happen to the next HLHS kid that needed a Norwood? Well, what did happen was 3 months later they did a Sano without me, I flew in 17 days later, kid was extubated in ICU for respiratory care only, and next to him was another un-operated HLHS kid, they wanted me to now show them a Modified Norwood 1 with typical BT shunt, so we did the child, extubated on afternoon of POD2, and there is a picture on our website of me with a Sano in one arm and Norwood in the other. What happened, well they did a couple more Sano's the rest of 2006 and early 2007 and all died (6), then I fly in on this trip and what is sitting in the ICU, a modified Norwood POD 3 with great hemodynamics, but still a little to puffy to extuba te. So, ball back to you buddy, what will happen to the next Shones Syndrome, I don't know but I have hope that is backed up by a historical perspective. Tea we are collecting the data from here for the 5 years of our program, hoping to present it at EACTS in Lisbon in September, but what it is going to show is the growth of a program that had an overall mortality rate of 18% the year before we came, doing nothing more complicated than Tets and some AV Canals, to a program with less than 5% mortality rate, and only 1/18 deaths this year in the arterial switch operation, a Norwood program that shows progress, a Fontan program started from nothing now with a mortality rate of less than 5%. I agree that you never?know what will happen, but with the right people, right support and right attitude, despite some problems, great things can be accomplished. Bill Or what will happen with the next "similar case" when Dr. Novick is absent. What actually changed there? There is the incident, a live child with some new future, to which Ani alluded. But what about the other side? I would propose nothing, a small step in another area, or least likely a quantum step (maybe only in desire at present) forward for the same result next time. It is also possible that success leads to a contrarian or peculiar response. I don't know. I just wonder. tea ----- Original Message ---- From: Ani Anyanwu To: openheart-l@lists.hsforum.com Sent: Thursday, November 29, 2007 9:48:46 PM Subject: RE: [HSF] Ahh, the Holiday Transfer. Would anyone do anything different? Yes. That Dr Novick was right doesn't mean the Chief was wrong. Maybe the Chief knows something we don't (e.g. about the healthcare provision or natural history after heart surgery in his country) and what might seem the best and successful therapy in one country might not necessarily be the same in another. What I would want to know is what is the likelihood that this particular 7 month old in his country would remain alive to see his 5th 10th 15th and 20th birthday after this life saving operation? Ani > Date: Thu, 29 Nov 2007 18:24:15 -0800> From: tacuff@swbell.net> Subject: Re: [HSF] Ahh, the Holiday Transfer. Would anyone do anything different?> To: OpenHeart-L@lists.hsforum.com> CC: > > How about the possibility in this case that both the Chief and you were right with different recommendations!> > tea> > > ----- Original Message ----> From: "ichfno@aol.com" > To: OpenHeart-L@lists.hsforum.com> Sent: Thursday, November 29, 2007 10:41:50 AM> Subject: Re: [HSF] Ahh, the Holiday Transfer. Would anyone do anything different?> > Okay, here is my do nothing story for the day. In a former Soviet Union Country at present, presented a child who is 7 months old, 5 KGS, had coarctation repair as newborn, at which time they did not address his MS, but did send to cath lab to balloon his stenotic aortic valve. No gradient after coarc, 60 gradient by echo after balloon, down from 90 gradient measured in lab, left him with 1-2 plus AI. So, now seven months later, has 22 mmHg peak mitral gradient and 1 plus MR, with single pap muscle by echo, 2-3 plus AI and 60 mmHG LVOTO gradient with subvalve 7mm. Massively dialated LA, LV dialated as well, cachectic, can see every rib, breathing 45 times/minute. Chief at the Institution returns from Moscow, tells mother child should go home to die, operation is not possible, even though we have scheduled child for an operation. Mother says, I cannot do nothing, I must do everything possible for my only child. Mother refuses advice of Chief, child goes> to operating room, Chie> f makes entire surgical team sign note stating that we know he has advised against surgery that is doomed to failure. We all sign!> > Child is in ICU, 0.08 epi, 0.75 milrinone, sternum closed, cvp 12, BP 95/68. Did Ross-Konno, spilt single pap muscle and opened both commissures, no LVOTO gradient, Mitral down to 4 mmHg, mild MR, no AI, no residual VSD, sometimes you just can't do nothing!> > > WNovick MD> > > > > If you reflect on your story, sometimes nothing is the hardest thing to do. > It does have the advantage, however, that one is able to reverse the choice with > better information or a change in the situation to change your odds...possibly > including the arrival of a "better" surgeon or better plan. > tea > > > > ----- Original Message ----> From: Michael Firstenberg > To: OpenHeart-L@lists.hsforum.com> Sent: Wednesday, November 28, 2007 9:18:51 PM> Subject: RE: [HSF] Ahh, the Holiday Transfer. Would anyone do anything > different?> > So - just dont do something, stand there....> > Michael Firstenberg > > -----Original Message-----> From: "Tea Acuff" > To: OpenHeart-L@lists.hsforum.com> Sent: 11/28/2007 9:55 PM> Subject: Re: [HSF] Ahh, the Holiday Transfer. Would anyone do anything > different?> > As per some of the other comments, he had a better chance with nothing. Your > findings would point to that although it is a calculated quess preop.> > tea> > > ----- Original Message ----> From: Michael Firstenberg > To: OpenHeart-L@lists.hsforum.com> Sent: Sunday, November 25, 2007 7:52:57 PM> Subject: Re: [HSF] Ahh, the Holiday Transfer. Would anyone do anything > different?> > The tear was at the SVG->PDA site going into the arch (as per CT) and > down a little, but did not appear to involve the native ostium nor > the valve - the AI appeared to be from being bicuspid/fused.> > > -michael> > > On Nov 25, 2007, at 8:44 PM, Tea Acuff wrote:> > > What did you find on opening the aorta? Did the dissection go > > proximal to the grafts? Was the dissection the cause of the AI or > > was that just the biscupid valve?> >> > tea> >> >> > ----- Original Message ----> > From: Michael Firstenberg > > To: OpenHeart-L@lists.hsforum.com> > Sent: Sunday, November 25, 2007 6:58:39 PM> > Subject: Re: [HSF] Ahh, the Holiday Transfer. Would anyone do > > anything different?> >> > he was a little wet - but not bleeding to death.> >> >> >> > -michael> >> >> >> >> > On Nov 25, 2007, at 7:48 PM, zzhoumd@pol.net wrote:> >> >>> >> Just wonder if Factor 7 may help.> >>> >> Sent via BlackBerry by AT&T> >>> >> -----Original Message-----> >> From: Michael Firstenberg > >>> >> Date: Sun, 25 Nov 2007 18:47:53> >> To:OpenHeart-L@lists.hsforum.com> >> Subject: [HSF] Ahh,> >> the Holiday Transfer. Would anyone do anything different?> >>> >>> >> The wonders of holiday in the U.S. is that we (academic medical> >> centers) seem to get all of transfers.> >> This was my case from yesterday and would be very interested in> >> comments (besides shipping to a better surgeon......).> >>> >> 61 year/old, hypertensive, diabetic, severe abdominal obesity (BMI> >> 48, 300 lbs, around 5' 4')> >> presents to outside hospital with refractory chest/back pain,> >> radiating to legs.> >> CT Angio - aortic dissection, just about the valve to the iliacs.> >> head/visceral/renal/femorals off true lumen (but very small)> >> Surgery resident from outside hospital calls me for transfer (on> >> cardizem drip for BP control, no beta-blockers, not working, should> >> we heparinize...... discussion for another time!!!)> >> "oh, I forgot to mention, he had a CABGx4 in June of this year)> >>> >> My response - esmolol and ship quickly> >> Upon arrival, still having pain, BP OK, neuro intact, faint femoral> >> pulses, strong radials (no A-line)> >> Reviewed still with our local Cardiology CT expert (lucky he was in> >> house)> >> - confirm dx> >> - all grafts patent, LIMA-LAD, SVG->PDA, SVG->Dx, SVG->Om> >> - 3 proximals coming off the ascending aorta> >> - LIMA lateral to sternum> >>> >> Taken emergently to OR> >> Axillary cannulation (nice artery)> >> Wire in right femoral vein (ugly groin, lots of fat, yeastly)> >> Intra-op TEE shows bicuspid aortic valve with mild/mod AI.> >> Open the chest (they missed midline on the CABG and went through a> >> bunch of ribs on the right- close to the RIMA)> >> Got in OK> >> tons of mediastinal fat plastered to pericardium, plastered to> >> epicardial fat.> >> NO, and I mean NO identifiable planes!> >> Finally found aorta after about an hr of digging - found old> >> cannulation site> >> aorta looks ugly as I exposed.> >> Finally found SVG to PDA graft - completely plastered to small right> >> atrium> >> cannulated right vein - went on, cooled> >> could not find "the heart/apex/etc) to vent - fortunately arrested> >> without fibbing (LV didnt look too bad on TEE while cooling)> >> Cooled to 18C (didnt even look for the LIMA - way laterally and> >> everything was a mess) -> kept feeding heart with cold blood> >> Finally got around aorta - circ arrest, opened up, trimmed to hemi-> >> arch - contained rupture, tear at right vein graft site> >> found "something to sew to" distally in arch (30 min of circ arrest> >> time)> >> went back on, started warming - blood coming from grafts, left main> >> and right (all good, I assumed)> >> aortic valve - bicuspid ->fused, but leaflets normal -> separated> >> left and non-cor leaflets and appeared to co-apt ok and hold water> >> went closed> >> (mobilzing for AVR would have been very difficult - at least for> >> me!)> >> On/off circ arrest, low flow, etc to fix leaks, mobilize, visualize,> >> etc....> >> Bioglue to proximal aorta layers and dissection plane.> >> Sewed proximal> >> root vent - cardiopledgia> >> Sewed on very scarred, friable SVG buttons (got the right mobilzed> >> off the RA once empty and repaired/resected tear)> >>> >> Took of x-clamp - slowly developed junction rhythm as warming more> >> came off pump eventually with lots of drugs, inhaled nitric> >> over an hour de-airing> >> TEE - still mild AI> >> - felt addressing would be futile> >> - 6 hours on pump.....30 min DHCA, 4 hr cross clamp (on and off)> >> Anesthesia up and down with tons of drugs/fluids/products/bicarb> >> big chest - wet lungs, hard to ventilate, very unstable, up/down> >> acidosis......(thought making urine???)> >> Very coagulopathic (would have liked to have had Aprotinin) but used> >> TA.....> >> Tons of products (INR>6, PTT unmeasurable, ACT after protamine>999,> >> platelts=18), but not bleeding too bad> >> re-enforced graft site and potential space to co-seal, flow-seal,> >> fibrilar, NuKnit, anything that I was allowed to leave in the chest> >> (although no potential space - other than right pleural space - to> >> bleed into)> >> Closed chest (modified weave and lots of wires through ribs)> >> meta-stable> >>> >> went out to talk to family.......called back in....became brady> >> cardiac as getting ready to move to bed....pulseless.....> >> chest open - heart dead.....open CPR....intra-cardiac epi/vaso...> >> TEE showed LV empty......(rupture into left chest? abd? something> >> else?)> >>> >> "the end"> >>> >> Please comment as I know many of you have been there (either on-line> >> or in private)..........> >>> >>> >> (fyi, this is the second post-CABG dissection we got this week - the> >> first one was only a month out and the redo was much easier)> >>> >> -michael> >>> >>> >>> >>> >>> >>> >>> >>> >>> >> _______________________________________________> >> OpenHeart-L mailing list> >>> >> Send postings to:> >> OpenHeart-L@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@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@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@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@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@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@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@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> -----------------------------------------> > > ________________________________________________________________________> More new features than ever. Check out the new AOL Mail ! - http://o.aolcdn.com/cdn.webmail.aol.com/mailtour/aol/en-us/text.htm?ncid=aolcmp00050000000003> _______________________________________________> OpenHeart-L mailing list> > Send postings to:> OpenHeart-L@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@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> ----------------------------------------- _________________________________________________________________ Who's friends with who and co-starred in what? http://www.searchgamesbox.com/celebrityseparation.shtml_______________________________________________ OpenHeart-L mailing list Send postings to: OpenHeart-L@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@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 ----------------------------------------- ________________________________________________________________________ More new features than ever. Check out the new AOL Mail ! - http://o.aolcdn.com/cdn.webmail.aol.com/mailtour/aol/en-us/text.htm?ncid=aolcmp00050000000003 _______________________________________________ OpenHeart-L mailing list Send postings to: OpenHeart-L@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 ----------------------------------------- From tacuff at swbell.net Sun Dec 2 19:37:43 2007 From: tacuff at swbell.net (Tea Acuff) Date: Sun Dec 2 22:39:10 2007 Subject: [HSF] -Prasanna and Sauerbraten-(OT) Message-ID: <154995.51536.qm@web81611.mail.mud.yahoo.com> Gabi, so if you are Swiss should you pray for heaven or hell? As usual I remain confused. tea ----- Original Message ---- From: gabi ford To: openheart-l@lists.hsforum.com Sent: Saturday, December 1, 2007 4:40:30 PM Subject: [HSF] -Prasanna and Sauerbraten-(OT) From: battr@medizin.uni-leipzig.de > He can not eat Sauerbraten because he is almost dead after many hours of > flight, train, tramway, bus, etc to arrive here. I am on duty, and cannot > carry him at home...let see tomorrow. May be he is more dead because of the > problems he had to fight to get the German Visa. He got it. Hello Prasanna and Robert, Don't make it sound as if the German authorities have complicated Transnationalvorschriftsbestimmungsregulierungen or somethin'!!!!!! ;) Please allow me to indulge in a joke regarding stereotypes of European folks: HEAVEN IS - where the French are the cooks - where the Italians are the lovers - where the Germans are the mechanics - where the Swiss run the hotels - where the British are the police HELL IS - where the Swiss are the lovers - where the British are the cooks - where the Italians run the hotels - where the French are the mechanics - where the Germans are the police Ciao, Gabi_______________________________________________ OpenHeart-L mailing list Send postings to: OpenHeart-L@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 ----------------------------------------- From tacuff at swbell.net Sun Dec 2 19:38:56 2007 From: tacuff at swbell.net (Tea Acuff) Date: Sun Dec 2 22:40:24 2007 Subject: [HSF] aortic cusp mass Message-ID: <220506.5770.qm@web81615.mail.mud.yahoo.com> so what do you think this round mass is? tea ----- Original Message ---- From: Prasanna Simha M To: OpenHeart-L@lists.hsforum.com Sent: Saturday, December 1, 2007 1:22:07 PM Subject: Re: [HSF] aortic cusp mass Tea, papillary fibroelastoma lookslikethe fronds of a sea anemone. I have seen 3 , 2 on the aortic valve and one on the mitral vavle . All presented with stroke. Prasanna On Nov 30, 2007 6:21 AM, Tea Acuff wrote: > I have an 82 year old woman asymptomatic with a 2cm smooth polypoid mass > based on tricuspid leaflet of the aortic valve. My partner recently did an > resection for a fibroelastoma of the same which only has a few reported > cases. Anyone seen this or a complication of this? It does not look or move > like a vegetation. > > tea > _______________________________________________ > OpenHeart-L mailing list > > Send postings to: > OpenHeart-L@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 > ----------------------------------------- > -- Prasanna Simha M _______________________________________________ OpenHeart-L mailing list Send postings to: OpenHeart-L@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 ----------------------------------------- From tacuff at swbell.net Sun Dec 2 19:41:44 2007 From: tacuff at swbell.net (Tea Acuff) Date: Sun Dec 2 22:42:13 2007 Subject: [HSF] Ahh, the Holiday Transfer. Would anyone do anything different? Message-ID: <846079.95363.qm@web81604.mail.mud.yahoo.com> So surgery is a "state of mind"? Interesting. Very interesting! tea ----- Original Message ---- From: Ben Bidstrup To: OpenHeart-L@lists.hsforum.com Sent: Saturday, December 1, 2007 5:39:30 AM Subject: Re: [HSF] Ahh, the Holiday Transfer. Would anyone do anything different? Roger Mee gave a talk on this very subject at the Asian Association Meeting in Bali (immediately preceding the World Climate Conference). It is far more than just a few surgeons, but a state of mind starting at the top. Applicable to adults surgery as well. >that leads to an important question : what are the variables and parameters >that determine the success of a certain surgical program ... let it be a >paediatric and neonatal cardiac Surgical program at a certain area - >Country- ........... is it just the Surgical Competency to perform a >certain set of procedures ?? .... I suppose it is enough then to have some >surgeons trained at the best centres in the world and return them back >"home" to perform such "Procedures" in any case anatomically diagnosed as a >certain Syndrome .... !!!! ......... is raising the surgical standards in a >certain milieu just limited to the ability to perform a certain technique >???? ... ani ? .. your input ? .. > >On Nov 30, 2007 6:02 AM, wrote: > >> Bill, >> Not to sound corny, but what you are doing really represents America at >> its best. I'm proud that guys like you can go out to these developing >> areas >> and help raise the surgical standards. Keep on keeping on. >> >> Hal >> >> >> >> **************************************Check out AOL's list of 2007's >> hottest >> products. >> (http://money.aol.com/special/hot-products-2007?NCID=aoltop00030000000001) >> _______________________________________________ >> OpenHeart-L mailing list >> >> Send postings to: >> OpenHeart-L@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@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 >----------------------------------------- -- Ben Bidstrup FRACS FRCSEd FEBCTS Consultant Cardiothoracic Surgeon _______________________________________________ OpenHeart-L mailing list Send postings to: OpenHeart-L@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 ----------------------------------------- From tacuff at swbell.net Sun Dec 2 19:43:31 2007 From: tacuff at swbell.net (Tea Acuff) Date: Sun Dec 2 22:45:02 2007 Subject: [HSF] IVC Mass Message-ID: <83947.72159.qm@web81610.mail.mud.yahoo.com> Neither seem to work as a prevention for heart disease in Indians. Maybe you should try something else. I would suggest a beer. tea ----- Original Message ---- From: Prasanna Simha M Cc: OpenHeart-L@lists.hsforum.com Sent: Sunday, December 2, 2007 9:55:41 AM Subject: Re: [HSF] IVC Mass Being vegetarian and teetotaller both are out !! But I ahve eaten a fantastic variety of cheeses On Dec 1, 2007 9:31 PM, wrote: > Prasanna: > I just saw you were writing from Leipzig! Please drink a beer and have > some saurbratten (sp?) for me. > > Her kidneys are normal. > > Ed Bender, MD > > ---- Prasanna Simha M wrote: > > Kidneys ? > > Prasanna from Leipzig !! > > > > On Nov 30, 2007 2:44 PM, wrote: > > > > > Normal pelvic CT scan > > > > > > ---- Hgrmd@aol.com wrote: > > > > Ed, > > > > How's her uterus? > > > > > > > > Hal > > > > > > > > > > > > > > > > **************************************Check out AOL's list of 2007's > > > hottest > > > > products. > > > > ( > > > > http://money.aol.com/special/hot-products-2007?NCID=aoltop00030000000001) > > > > _______________________________________________ > > > > OpenHeart-L mailing list > > > > > > > > Send postings to: > > > > OpenHeart-L@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@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 > > > ----------------------------------------- > > > > > > > > > > > -- > > Prasanna Simha M > > _______________________________________________ > > OpenHeart-L mailing list > > > > Send postings to: > > OpenHeart-L@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 > > ----------------------------------------- > > -- Prasanna Simha M _______________________________________________ OpenHeart-L mailing list Send postings to: OpenHeart-L@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 ----------------------------------------- From tacuff at swbell.net Sun Dec 2 19:50:12 2007 From: tacuff at swbell.net (Tea Acuff) Date: Sun Dec 2 22:50:41 2007 Subject: [HSF] milrinone Message-ID: <710923.68832.qm@web81608.mail.mud.yahoo.com> I tried to look up the meaning of lusitropic. Never could get a clear idea. I did find an interesting article for primary care physicians that claimed the treatment of diastolic heart failure (despite saying there was no clear defintion of diastolic heart failure) included the following: Treatment by present guidelines....Evidence class A Then a list of multiple therapies including beta blockers, diuretics, revascularization, etc. ....all listed as evidence class C! Imagine. tea ----- Original Message ---- From: Prasanna Simha M To: OpenHeart-L@lists.hsforum.com Sent: Sunday, December 2, 2007 8:59:01 AM Subject: Re: [HSF] milrinone There are articles and especially in the pediatric age group for eg it has been shown to be of benefit in the arterial switch and tetralogy etc. Basically I believe its best use is in patients with pulmonary hypertension and also RVdsfunction and in any condition where ventricular relaxation is impaired as it is virtually the only inotrope with lusitropic action. I would use it judiciously in these cases. Remember that itcan ccasue a fall in SVR and so adequate volume loading (best given on the pump and warn the perfusionist of a possible fall in the reservoir level -) In some cases it may be of benefit to combine it with Norepinephrine. Prasanna (in Leipzig at present) On Dec 2, 2007 3:03 AM, james le wrote: > Thanks Dr Prasanna, > > Are there any studies which compared milrinone versus other inotropes > which showed the superiority of milrinone regarding outcomes? > > Prasanna Simha M wrote: > Yes, works well in patients with dysfunctional RV's and stiff LV's. I use > them in patients with severe PH, RV dysfunction and tetrology patients. > They reduce inotropic usage and ICU time. > Prasanna > > > On 11/30/07, james le wrote: > > > > Is there any evidence of milrinone usage improving the out comes > > following cardiac surgery? > > > > [I work in public hospital where there is some on going discussion about > > its cost effectiveness] > > > > > > --------------------------------- > > Get easy, one-click access to your favorites. Make Yahoo! your homepage. > > _______________________________________________ > > OpenHeart-L mailing list > > > > Send postings to: > > OpenHeart-L@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 > > ----------------------------------------- > > > > > > -- > Prasanna Simha M > _______________________________________________ > OpenHeart-L mailing list > > Send postings to: > OpenHeart-L@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 > ----------------------------------------- > > > > --------------------------------- > Be a better sports nut! Let your teams follow you with Yahoo Mobile. Try > it now. > _______________________________________________ > OpenHeart-L mailing list > > Send postings to: > OpenHeart-L@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 > ----------------------------------------- > -- Prasanna Simha M _______________________________________________ OpenHeart-L mailing list Send postings to: OpenHeart-L@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 ----------------------------------------- From tacuff at swbell.net Sun Dec 2 20:02:40 2007 From: tacuff at swbell.net (Tea Acuff) Date: Sun Dec 2 23:04:08 2007 Subject: [HSF] milrinone Message-ID: <166864.67560.qm@web81611.mail.mud.yahoo.com> I take your question and situation a little differently. Does it work? Absolutely. Does it improve outcomes? Compared to what? I have used it often in bad situations. I have also worked with an anesthesiologist that never uses it, and my results seem just as good with him if not better than others. It is a vasodilator, pulmonary (partially secondary due to lusitropic effect?) and arterial, as well as an inotrope. tea ----- Original Message ---- From: james le To: OpenHeart-L@lists.hsforum.com Sent: Friday, November 30, 2007 11:18:57 AM Subject: [HSF] milrinone Is there any evidence of milrinone usage improving the out comes following cardiac surgery? [I work in public hospital where there is some on going discussion about its cost effectiveness] --------------------------------- Get easy, one-click access to your favorites. Make Yahoo! your homepage. _______________________________________________ OpenHeart-L mailing list Send postings to: OpenHeart-L@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 ----------------------------------------- From tacuff at swbell.net Sun Dec 2 20:55:55 2007 From: tacuff at swbell.net (Tea Acuff) Date: Sun Dec 2 23:56:27 2007 Subject: [HSF] aortic cusp mass Message-ID: <152050.6713.qm@web81610.mail.mud.yahoo.com> An interesting query. Perhaps it is ambiguous whether the woman, the mass, or the valve are all indeed asymptomatic or if there were symptoms would the three be related. Your solution raises the issue as to whether your present calling of LVAD director is a logical symptom of your avoidance of asymptomatic (HF?)patients. And since I have been ragging on guidelines for a while, at what age are they considered inappropiate (at least for "asymptomatic" patients). Nothing in this of course means that have any disagreement with your question or admonition. Lastly for Ben. Should we put a comma in "asymptomatic, 80 year old woman" or not? What would be the "quideline"? Who gets to decide on the symptoms the doctor or patient? Is any 80 year old completely asymptomatic? Is any 30 year old? tea tea ----- Original Message ---- From: Ani Anyanwu To: openheart-l@lists.hsforum.com Sent: Friday, November 30, 2007 6:56:49 AM Subject: RE: [HSF] aortic cusp mass What business did an asymptomatic 82 year old have going near an echocardiogram machine? Only in America I suppose. The poor sleeping dog has probably been asleep for years if not decades and now is awake and has woken up too all those around this poor lady. Another reminder to us not to run tests in asymptomatic patients except one is ready to deal with whatever one finds. Ani > Date: Thu, 29 Nov 2007 21:23:08 -0800> From: tacuff@swbell.net> To: OpenHeart-L@lists.hsforum.com> CC: > Subject: [HSF] aortic cusp mass> > I have an 82 year old woman asymptomatic with a 2cm smooth polypoid mass based on a tricuspid leaflet of the aortic valve. My partner recently did an resection for a fibroelastoma of the same which there are a few reported cases. Anyone seen this or a complication of this? It does not look or move like a vegetation.> > tea> _______________________________________________> OpenHeart-L mailing list> > Send postings to:> OpenHeart-L@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> ----------------------------------------- _________________________________________________________________ Telly addicts unite! http://www.searchgamesbox.com/tvtown.shtml_______________________________________________ OpenHeart-L mailing list Send postings to: OpenHeart-L@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 ----------------------------------------- From gabiford at hotmail.com Mon Dec 3 05:00:26 2007 From: gabiford at hotmail.com (gabi ford) Date: Mon Dec 3 00:00:54 2007 Subject: [HSF] -Prasanna and Sauerbraten-(OT) In-Reply-To: <154995.51536.qm@web81611.mail.mud.yahoo.com> References: <154995.51536.qm@web81611.mail.mud.yahoo.com> Message-ID: From: tacuff@swbell.net> so if you are Swiss should you pray for heaven or hell? Tea, I suppose that depends on whether one wanted to get laid, have a nice meal or get the Benz repaired. :) Gabi > HEAVEN IS> - where the French are the cooks> - where the Italians are the lovers> - where the Germans are the mechanics> - where the Swiss run the hotels> - where the British are the police> > HELL IS> - where the Swiss are the lovers> - where the British are the cooks> - where the Italians run the hotels> - where the French are the mechanics> - where the Germans are the police> > Ciao,> > Gabi_______________________________________________ From donross at bigpond.com Mon Dec 3 17:20:14 2007 From: donross at bigpond.com (Donald Ross) Date: Mon Dec 3 01:22:10 2007 Subject: [HSF] milrinone In-Reply-To: <89c4ed2d0712020659s5d8adb7al6f3a7ee6a4a0202d@mail.gmail.com> References: <89c4ed2d0712010212t4fa3d60eva7dc740b81650c8a@mail.gmail.com> <313108.90122.qm@web63013.mail.re1.yahoo.com> <89c4ed2d0712020659s5d8adb7al6f3a7ee6a4a0202d@mail.gmail.com> Message-ID: We us it a lot and really think it is beneficial but I have no data. If there were financial constraints we would undoubtedly use less but not give it up for serious myocardial dysfunction. Don On 03/12/2007, at 1:59 AM, Prasanna Simha M wrote: > There are articles and especially in the pediatric age group for > eg it has > been shown to be of benefit in the arterial switch and tetralogy etc. > Basically I believe its best use is in patients with pulmonary > hypertension > and also RVdsfunction and in any condition where ventricular > relaxation is > impaired as it is virtually the only inotrope with lusitropic > action. I > would use it judiciously in these cases. Remember that itcan ccasue > a fall > in SVR and so adequate volume loading (best given on the pump and > warn the > perfusionist of a possible fall in the reservoir level -) In some > cases it > may be of benefit to combine it with Norepinephrine. > Prasanna (in Leipzig at present) > > On Dec 2, 2007 3:03 AM, james le wrote: > >> Thanks Dr Prasanna, >> >> Are there any studies which compared milrinone versus other >> inotropes >> which showed the superiority of milrinone regarding outcomes? >> >> Prasanna Simha M wrote: >> Yes, works well in patients with dysfunctional RV's and stiff >> LV's. I use >> them in patients with severe PH, RV dysfunction and tetrology >> patients. >> They reduce inotropic usage and ICU time. >> Prasanna >> >> >> On 11/30/07, james le wrote: >>> >>> Is there any evidence of milrinone usage improving the out comes >>> following cardiac surgery? >>> >>> [I work in public hospital where there is some on going >>> discussion about >>> its cost effectiveness] >>> >>> >>> --------------------------------- >>> Get easy, one-click access to your favorites. Make Yahoo! your >>> homepage. >>> _______________________________________________ >>> OpenHeart-L mailing list >>> >>> Send postings to: >>> OpenHeart-L@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 >>> ----------------------------------------- >>> >> >> >> >> -- >> Prasanna Simha M >> _______________________________________________ >> OpenHeart-L mailing list >> >> Send postings to: >> OpenHeart-L@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 >> ----------------------------------------- >> >> >> >> --------------------------------- >> Be a better sports nut! Let your teams follow you with Yahoo >> Mobile. Try >> it now. >> _______________________________________________ >> OpenHeart-L mailing list >> >> Send postings to: >> OpenHeart-L@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 >> ----------------------------------------- >> > > > > -- > Prasanna Simha M > _______________________________________________ > OpenHeart-L mailing list > > Send postings to: > OpenHeart-L@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 > ----------------------------------------- From battr at medizin.uni-leipzig.de Mon Dec 3 08:13:21 2007 From: battr at medizin.uni-leipzig.de (Dr. Roberto Battellini) Date: Mon Dec 3 02:05:12 2007 Subject: AW: [HSF] aortic cusp mass In-Reply-To: <152050.6713.qm@web81610.mail.mud.yahoo.com> References: <152050.6713.qm@web81610.mail.mud.yahoo.com> Message-ID: <003401c8357b$fd0ac490$b3160a06@HZLPC0679> Tea, can you post the images? Roberto -----Urspr?ngliche Nachricht----- Von: openheart-l-bounces@lists.hsforum.com [mailto:openheart-l-bounces@lists.hsforum.com] Im Auftrag von Tea Acuff Gesendet: Montag, 3. Dezember 2007 05:56 An: OpenHeart-L@lists.hsforum.com Betreff: Re: [HSF] aortic cusp mass An interesting query. Perhaps it is ambiguous whether the woman, the mass, or the valve are all indeed asymptomatic or if there were symptoms would the three be related. Your solution raises the issue as to whether your present calling of LVAD director is a logical symptom of your avoidance of asymptomatic (HF?)patients. And since I have been ragging on guidelines for a while, at what age are they considered inappropiate (at least for "asymptomatic" patients). Nothing in this of course means that have any disagreement with your question or admonition. Lastly for Ben. Should we put a comma in "asymptomatic, 80 year old woman" or not? What would be the "quideline"? Who gets to decide on the symptoms the doctor or patient? Is any 80 year old completely asymptomatic? Is any 30 year old? tea tea ----- Original Message ---- From: Ani Anyanwu To: openheart-l@lists.hsforum.com Sent: Friday, November 30, 2007 6:56:49 AM Subject: RE: [HSF] aortic cusp mass What business did an asymptomatic 82 year old have going near an echocardiogram machine? Only in America I suppose. The poor sleeping dog has probably been asleep for years if not decades and now is awake and has woken up too all those around this poor lady. Another reminder to us not to run tests in asymptomatic patients except one is ready to deal with whatever one finds. Ani > Date: Thu, 29 Nov 2007 21:23:08 -0800> From: tacuff@swbell.net> To: OpenHeart-L@lists.hsforum.com> CC: > Subject: [HSF] aortic cusp mass> > I have an 82 year old woman asymptomatic with a 2cm smooth polypoid mass based on a tricuspid leaflet of the aortic valve. My partner recently did an resection for a fibroelastoma of the same which there are a few reported cases. Anyone seen this or a complication of this? It does not look or move like a vegetation.> > tea> _______________________________________________> OpenHeart-L mailing list> > Send postings to:> OpenHeart-L@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> ----------------------------------------- _________________________________________________________________ Telly addicts unite! http://www.searchgamesbox.com/tvtown.shtml__________________________________ _____________ OpenHeart-L mailing list Send postings to: OpenHeart-L@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@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 ----------------------------------------- From grescigno at mac.com Mon Dec 3 08:59:46 2007 From: grescigno at mac.com (Macbook) Date: Mon Dec 3 03:01:59 2007 Subject: [HSF] aortic valve echo study (addendum) Message-ID: I am referring to the last message I posted. If you are not able to see the clip or if you would like to see more echo images and another clip of the valve I am asking your advice, please go to my idisk and access the public folder: idisk.mac.com/grescigno-Public. There is a folder named mild aortic valve disease. Thank you Giuseppe From mmlevinson at hsforum.com Mon Dec 3 03:04:00 2007 From: mmlevinson at hsforum.com (Mark Levinson) Date: Mon Dec 3 04:04:30 2007 Subject: [HSF] IVC Mass In-Reply-To: References: Message-ID: <9AB96802-BAF6-4454-8443-967C973D2335@hsforum.com> On Nov 29, 2007, at 8:44 PM, Edward Bender wrote: > I know that this isn't a cardiac case, but I wanted to see if this > mass in the IVC is familiar to any of the members. > This is a healthy, asymptomatic 22 year old female radiology tech > student who was playing around with the ultrasound machine. She > found a filling defect in her IVC and asked one of the radiologists > about it. She then underwent a CT angio which is composited below. > The renal veins and iliac veins are without filling defect. She > had venous doppler studies of the lower extremities which are > normal. She had an echocardiogram which is normal. She has no > symptoms whatsoever. She does take oral contraceptives but does > not smoke. She has never had any injuries major illnesses, etc. > > I don't understand why she should have this filling defect, and, > doing a literature/x-ray search, the only thing that looks like > this is a leiomyosarcoma. If anyone has seen a case like this, I > would appreciate some incite into differential diagnosis (beyond > thrombus and sarcoma), best means of diagnosis, and appropriate > treatment. > > Could you get a piece of this with a cardiac biopsy forceps. I worry about a hemangiosarcoma, but I bet its more likely thrombus attached to the wall..... Maybe a two month trial of warfarin. If still there, then transvenous biopsy under ultrasound guidance (easier said than done!) Mark Levinson, MD. Founder, Editor-in-Chief The Heart Surgery Forum? Multimedia Cardiothoracic Journal URL: http://www.hsforum.com URL: http://newoptionsinheartsurgery.com Emali: mmlevinson@hsforum.com From john_pj15 at yahoo.com Mon Dec 3 08:58:07 2007 From: john_pj15 at yahoo.com (john pj) Date: Mon Dec 3 11:58:37 2007 Subject: [HSF] IVC Mass In-Reply-To: <9AB96802-BAF6-4454-8443-967C973D2335@hsforum.com> Message-ID: <290872.51904.qm@web35901.mail.mud.yahoo.com> we recently had a patient referred to us as ?RA myoma ? RA Thrombus[7*8 cm ] extending into IVC. CT scan chest done to asess rt lower lobe collapse showed Hepatoma extending in to rt atrium. Mark Levinson wrote: On Nov 29, 2007, at 8:44 PM, Edward Bender wrote: > I know that this isn't a cardiac case, but I wanted to see if this > mass in the IVC is familiar to any of the members. > This is a healthy, asymptomatic 22 year old female radiology tech > student who was playing around with the ultrasound machine. She > found a filling defect in her IVC and asked one of the radiologists > about it. She then underwent a CT angio which is composited below. > The renal veins and iliac veins are without filling defect. She > had venous doppler studies of the lower extremities which are > normal. She had an echocardiogram which is normal. She has no > symptoms whatsoever. She does take oral contraceptives but does > not smoke. She has never had any injuries major illnesses, etc. > > I don't understand why she should have this filling defect, and, > doing a literature/x-ray search, the only thing that looks like > this is a leiomyosarcoma. If anyone has seen a case like this, I > would appreciate some incite into differential diagnosis (beyond > thrombus and sarcoma), best means of diagnosis, and appropriate > treatment. > > Could you get a piece of this with a cardiac biopsy forceps. I worry about a hemangiosarcoma, but I bet its more likely thrombus attached to the wall..... Maybe a two month trial of warfarin. If still there, then transvenous biopsy under ultrasound guidance (easier said than done!) Mark Levinson, MD. Founder, Editor-in-Chief The Heart Surgery Forum? Multimedia Cardiothoracic Journal URL: http://www.hsforum.com URL: http://newoptionsinheartsurgery.com Emali: mmlevinson@hsforum.com _______________________________________________ OpenHeart-L mailing list Send postings to: OpenHeart-L@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 ----------------------------------------- --------------------------------- Be a better friend, newshound, and know-it-all with Yahoo! Mobile. Try it now. From yadavluck at yahoo.com Mon Dec 3 09:06:26 2007 From: yadavluck at yahoo.com (yadav del) Date: Mon Dec 3 12:06:55 2007 Subject: [HSF] pre op vit k Message-ID: <722697.2455.qm@web63011.mail.re1.yahoo.com> Does pre op vitamin K decrease post op bleeding? Any disdvantage of using Vit k is known? --------------------------------- Looking for last minute shopping deals? Find them fast with Yahoo! Search. From prasannasimha at gmail.com Mon Dec 3 21:13:53 2007 From: prasannasimha at gmail.com (Prasanna Simha M) Date: Mon Dec 3 15:20:27 2007 Subject: [HSF] milrinone In-Reply-To: <710923.68832.qm@web81608.mail.mud.yahoo.com> References: <710923.68832.qm@web81608.mail.mud.yahoo.com> Message-ID: <89c4ed2d0712031213l5097ebd9gfc538adb8f93ef2a@mail.gmail.com> lusitropic - failure of relaxation - go to the gym and lift an inappropriate amount of weights and then your arms and legs have a loss of lusitrophy !! Prasanna On Dec 3, 2007 4:50 AM, Tea Acuff wrote: > I tried to look up the meaning of lusitropic. Never could get a clear > idea. I did find an interesting article for primary care physicians that > claimed the treatment of diastolic heart failure (despite saying there was > no clear defintion of diastolic heart failure) included the following: > > Treatment by present guidelines....Evidence class A > Then a list of multiple therapies including beta blockers, diuretics, > revascularization, etc. ....all listed as evidence class C! > > Imagine. > > tea > > > ----- Original Message ---- > From: Prasanna Simha M > To: OpenHeart-L@lists.hsforum.com > Sent: Sunday, December 2, 2007 8:59:01 AM > Subject: Re: [HSF] milrinone > > There are articles and especially in the pediatric age group for eg it > has > been shown to be of benefit in the arterial switch and tetralogy etc. > Basically I believe its best use is in patients with pulmonary > hypertension > and also RVdsfunction and in any condition where ventricular relaxation is > impaired as it is virtually the only inotrope with lusitropic action. I > would use it judiciously in these cases. Remember that itcan ccasue a fall > in SVR and so adequate volume loading (best given on the pump and warn the > perfusionist of a possible fall in the reservoir level -) In some cases it > may be of benefit to combine it with Norepinephrine. > Prasanna (in Leipzig at present) > > On Dec 2, 2007 3:03 AM, james le wrote: > > > Thanks Dr Prasanna, > > > > Are there any studies which compared milrinone versus other inotropes > > which showed the superiority of milrinone regarding outcomes? > > > > Prasanna Simha M wrote: > > Yes, works well in patients with dysfunctional RV's and stiff LV's. I > use > > them in patients with severe PH, RV dysfunction and tetrology patients. > > They reduce inotropic usage and ICU time. > > Prasanna > > > > > > On 11/30/07, james le wrote: > > > > > > Is there any evidence of milrinone usage improving the out comes > > > following cardiac surgery? > > > > > > [I work in public hospital where there is some on going discussion > about > > > its cost effectiveness] > > > > > > > > > --------------------------------- > > > Get easy, one-click access to your favorites. Make Yahoo! your > homepage. > > > _______________________________________________ > > > OpenHeart-L mailing list > > > > > > Send postings to: > > > OpenHeart-L@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 > > > ----------------------------------------- > > > > > > > > > > > -- > > Prasanna Simha M > > _______________________________________________ > > OpenHeart-L mailing list > > > > Send postings to: > > OpenHeart-L@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 > > ----------------------------------------- > > > > > > > > --------------------------------- > > Be a better sports nut! Let your teams follow you with Yahoo Mobile. Try > > it now. > > _______________________________________________ > > OpenHeart-L mailing list > > > > Send postings to: > > OpenHeart-L@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 > > ----------------------------------------- > > > > > > -- > Prasanna Simha M > _______________________________________________ > OpenHeart-L mailing list > > Send postings to: > OpenHeart-L@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@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 > ----------------------------------------- > -- Prasanna Simha M From valdretemd at shaw.ca Mon Dec 3 12:21:30 2007 From: valdretemd at shaw.ca (V. Aldrete, M.D.) Date: Mon Dec 3 15:25:26 2007 Subject: [HSF] aortic valve echo study (addendum) In-Reply-To: References: Message-ID: <34F539CE-8BB7-4612-830A-445B8D705506@shaw.ca> Giuseppe, I followed your instructions, but although I can see the page all right, I cannot open any of its files. I am enclosing a picture of the window as I saw it. Victor -------------- next part -------------- A non-text attachment was scrubbed... Name: iDisk.jpg Type: image/jpeg Size: 76929 bytes Desc: not available Url : http://mmp.cjp.com/pipermail/openheart-l/attachments/20071203/1ba1d773/iDisk-0001.jpg -------------- next part -------------- On Dec 2, 2007, at 11:59 PM, Macbook wrote: > I am referring to the last message I posted. If you are not able to > see the clip or if you would like to see more echo images and > another clip of the valve I am asking your advice, please go to my > idisk and access the public folder: > > idisk.mac.com/grescigno-Public. There is a folder named mild aortic > valve disease. Thank you > > Giuseppe > _______________________________________________ > OpenHeart-L mailing list > > Send postings to: > OpenHeart-L@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 anddisclaimers posted at: > http://www.hsforum.com/listdisclaim > ----------------------------------------- From grescigno at mac.com Mon Dec 3 22:38:45 2007 From: grescigno at mac.com (Macbook) Date: Mon Dec 3 16:41:01 2007 Subject: [HSF] aortic valve echo study (addendum) In-Reply-To: <34F539CE-8BB7-4612-830A-445B8D705506@shaw.ca> References: <34F539CE-8BB7-4612-830A-445B8D705506@shaw.ca> Message-ID: <5436C3BC-EB04-45A4-A545-57BD85ED310D@mac.com> Victor, I don't know why you cannot upload the files. If you wish I can send the files directly to your email. However I see that the first message has been refused by the HSF server. This was the original message: Dear collegues, your opinion about this patient: 63 yo, male, several risks factors, recent ACS: 3 vessel disease, mild biventricular disfunction (EF around 50%, RV moderately dilated). Echo preop showed an ugly aortic valve without significant gradient (18 mmHg max) and mild-moderate regurg). TEE confirmed these data. Two cusps were fibrotic and some calcium was present but the valve should not be replaced according to the recent guidelines. I did just a mammary Y graft and a veind on PD. I prepared the patient to a scond operation (pericardial closure, Co-seal, etc). Do you agree? Thank you Giuseppe Giuseppe Rescigno MD Cardiac Surgery Dept There was a short clip of the valve attached to the message but the dimensions were probably too large to be accepted by the HSF. Giuseppe Il giorno 03/dic/07, alle ore 21:21, V. Aldrete, M.D. ha scritto: > Giuseppe, > > I followed your instructions, but although I can see the page all > right, I cannot open any of its files. > > I am enclosing a picture of the window as I saw it. > > Victor > > > > On Dec 2, 2007, at 11:59 PM, Macbook wrote: > >> I am referring to the last message I posted. If you are not able >> to see the clip or if you would like to see more echo images and >> another clip of the valve I am asking your advice, please go to my >> idisk and access the public folder: >> >> idisk.mac.com/grescigno-Public. There is a folder named mild >> aortic valve disease. Thank you >> >> Giuseppe >> _______________________________________________ >> OpenHeart-L mailing list >> >> Send postings to: >> OpenHeart-L@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 anddisclaimers posted at: >> http://www.hsforum.com/listdisclaim >> ----------------------------------------- > > _______________________________________________ > OpenHeart-L mailing list > > Send postings to: > OpenHeart-L@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 > ----------------------------------------- From benjamin.bidstrup at bigpond.com Tue Dec 4 09:26:36 2007 From: benjamin.bidstrup at bigpond.com (Ben Bidstrup) Date: Mon Dec 3 18:27:55 2007 Subject: [HSF] aortic valve echo study (addendum) In-Reply-To: <5436C3BC-EB04-45A4-A545-57BD85ED310D@mac.com> References: <34F539CE-8BB7-4612-830A-445B8D705506@shaw.ca> <5436C3BC-EB04-45A4-A545-57BD85ED310D@mac.com> Message-ID: Open the web page. Then click on the little arrow on the right to download the file. >Victor, > >I don't know why you cannot upload the files. If you wish I can send >the files directly to your email. However I see that the first >message has been refused by the HSF server. This was the original >message: > >Dear collegues, > >your opinion about this patient: 63 yo, male, several risks factors, >recent ACS: 3 vessel disease, mild biventricular disfunction (EF >around 50%, RV moderately dilated). Echo preop showed an ugly aortic >valve without significant gradient (18 mmHg max) and mild-moderate >regurg). TEE confirmed these data. Two cusps were fibrotic and some >calcium was present but the valve should not be replaced according >to the recent guidelines. I did just a mammary Y graft and a veind >on PD. I prepared the patient to a scond operation (pericardial >closure, Co-seal, etc). Do you agree? > >Thank you > > >Giuseppe > >Giuseppe Rescigno MD >Cardiac Surgery Dept > >There was a short clip of the valve attached to the message but the >dimensions were probably too large to be accepted by the HSF. > >Giuseppe > >Il giorno 03/dic/07, alle ore 21:21, V. Aldrete, M.D. ha scritto: > >>Giuseppe, >> >>I followed your instructions, but although I can see the page all >>right, I cannot open any of its files. >> >>I am enclosing a picture of the window as I saw it. >> >>Victor >> >> >> >>On Dec 2, 2007, at 11:59 PM, Macbook wrote: >> >>>I am referring to the last message I posted. If you are not able >>>to see the clip or if you would like to see more echo images and >>>another clip of the valve I am asking your advice, please go to my >>>idisk and access the public folder: >>> >>>idisk.mac.com/grescigno-Public. There is a folder named mild >>>aortic valve disease. Thank you >>> >>>Giuseppe >>>_______________________________________________ >>>OpenHeart-L mailing list >>> >>>Send postings to: >>>OpenHeart-L@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 anddisclaimers posted at: >>>http://www.hsforum.com/listdisclaim >>>----------------------------------------- >> >>_______________________________________________ >>OpenHeart-L mailing list >> >>Send postings to: >> OpenHeart-L@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@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 anddisclaimers posted at: >http://www.hsforum.com/listdisclaim >----------------------------------------- -- Ben Bidstrup FRACS FRCSEd FEBCTS Consultant Cardiothoracic Surgeon From wftjrtyler at aol.com Mon Dec 3 18:26:54 2007 From: wftjrtyler at aol.com (wftjrtyler@aol.com) Date: Mon Dec 3 18:31:13 2007 Subject: [HSF] Economics in one lesson Message-ID: In a message dated 12/2/2007 9:23:53 P.M. Central Standard Time,