[HSF] Residual VSD after Amplatz Closure

[Nasser F. Abou'Seada]

" ? Pentoxiphylline reduces dp/dt of the jet and improves RBC trauma
resistence ?" .... please Prasanna ... elaborate ..

NFA

On Dec 10, 2007 12:16 AM, Prasanna Simha M <prasannasimha at gmail.com> wrote:

> Done in the day time ? I think we are talking about elective scheduling.
> One way to get out of jet hemolysis that has occasionally worked for me in
> the past (Now not common as we use Goretex instead of Dacron for patches
> etc) is to give a Beta blocker and Pentoxyfillin (reduces the Dp/Dt of the
> jet and improves RBC trauma resistance and hopefully allows
> endothelialization after which the hemolysis subsides despite the small
> high
> velocty jets.)
> Prasanna
>
> On Dec 10, 2007 6:42 AM, Tea Acuff <tacuff at swbell.net> wrote:
>
> > 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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>
> --
> Prasanna Simha M
> _______________________________________________
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