[HSF] Residual VSD after Amplatz Closure

[Tea Acuff]

I could be wrong as always, but is there not a lot of mixing and matching of operations and pathologies going on here on this thread?  This is a trauma case in all likely, so go to the injury under control. No? The difference is we know the "two dudes" and it can be done electively in the day time..

tea


----- Original Message ----
From: Prasanna Simha M <prasannasimha at gmail.com>
To: OpenHeart-L at lists.hsforum.com
Sent: Sunday, December 9, 2007 11:32:08 PM
Subject: Re: [HSF] Residual VSD after Amplatz Closure

The RVOT approach would be better kept aslast reserve (associated long term
with arrhythmias etc. (This is the same case we talked about  in the meet
?.) It can be pulled out if recent or covered witth a patch. Problem is that
if it is associated with significant hemolysis and the AR jet is hitting it
it needs to be removed.(as the jet would be from the LV side
One way to decide where to approach is by palpating the VSD  jet pre CPB -
if at the AV groove - via tricuspid valve , RVOT then PA or RVOT. Helps to
limit the RVOT incision too.
Prasanna

On Dec 10, 2007 1:49 AM, <Hgrmd at aol.com> wrote:

> Homayoun,
>  Thanks for the reply.  I hadn't thought of the RVOT  approach.   Since I'm
> going to take out the aortic prosthesis anyway, I'll  probably go that
> route
> first.  Hopefully, it will be fairly endothelialized  since it's been
> about 6
> months since surgery.  If the tissue quality is  still bad, then I'll look
> at it
> via the right atrium.  If the exposure is  bad, then I guess I'll try the
> RVOT.  Again, since I don't have any  experience with it, does this device
> need
> to be removed, or is it OK just to  cover it?
>
> Hal
>
>
>
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-- 
Prasanna Simha M
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