AW: [HSF] Percutaneous Valves

[Nasser F. Abou'Seada]

Dear Ani
I totally concur with you 

NFA 

> -----Original Message-----
> From: openheart-l-bounces at lists.hsforum.com [mailto:openheart-l-
> bounces at lists.hsforum.com] On Behalf Of Ani Anyanwu
> Sent: Saturday, February 03, 2007 5:35 AM
> To: OpenHeart-L at lists.hsforum.com
> Subject: Re: AW: [HSF] Percutaneous Valves
> 
> Several of these patients too sick for surgery will end up with open AVR
when the
> percutaneous one fails and suddenly they are no longer too sick. I have
seen this with
> stented left main and also balloon valvuloplasty where the indication for
percutaneous
> intervention was done because too sick - that fails and they become sicker
and then
> call a surgeon.
> 
> Regarding transpaical - no one is sticking one of those in me. Anyone who
trained in
> london, where venting through the LV apex is still prevalent, would have
seen enough
> disasters from apical cannulation to know that it is a part of the heart
best left alone...
> 
> Ani
>   ----- Original Message -----
>   From: Michael Firstenberg<mailto:msfirst at gmail.com>
>   To: OpenHeart-L at lists.hsforum.com<mailto:OpenHeart-L at lists.hsforum.com>
>   Sent: Friday, February 02, 2007 12:46 PM
>   Subject: Re: AW: [HSF] Percutaneous Valves
> 
> 
>   These are not really all of that bad.... so far.... for us "open valve
>   surgeons".
>   I have seen several first hand and right now they really are an
>   Institutional Tour de Force.  Think of it - patients "too sick for AVR"
(of
>   course we can debate that definition).  The ones I have seen, required
very
>   (and I mean very) skilled 1) Echocardiologists 2) CT anesthesia 3)
>   Interventional Cards AND 4) an Aortic surgeon - all working together.
Even
>   with this group, they are still far from ready for application outside
of
>   the meccas.  And, it is not just putting them in, but also dealing with
>   potential problems and co-morbidities.
> 
>   Besides, as we know, "knock off" a few "heathy" patients who
>   could/should/would have had AVRs and someone (administration? risk
>   management? legal? common sense?) will shut down this activity real
quick.
>   These are no longer the days of Grundzig, Battista, Gibbon, etc......
> 
> 
>   -michael
> 
> 
> 
>   On 2/2/07, Hgrmd at aol.com<mailto:Hgrmd at aol.com>
> <Hgrmd at aol.com<mailto:Hgrmd at aol.com>> wrote:
>   >
>   > Nand,
>   > I agree.  Percutaneous AVI's are coming.  Get ready.
>   > Hal
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