[HSF] Calcified aortic stenosis

[Tea Acuff]

Tom,
Did you ignore the little side comment about pulmonary problems after CAB 6 years ago? Is a redo circ arrest case for root replacement really only 10% in this group (I mean this patient specifically, smoker, dyspnea, small) After all the STS mortality for primary CAB is probably close to 4-5% for her.
tea


----- Original Message ----
From: Mitch Lirtzman <drmitch at cox.net>
To: OpenHeart-L at hsforum.com
Sent: Saturday, June 30, 2007 6:48:53 PM
Subject: [HSF] Calcified aortic stenosis


To the forum. I know we've covered this type of problem in previous 
discussions, but...

An old patient of mine, 62yo petite diabetic female, unrepentant smoker 
2ppd x 50yrs, had successful CABx3 in 2001- LIMA/ 2 veins. She's been 
complaining of increasing dyspnea for several months and referred her back 
to her cardiologist to investigate. The bottom line is she has critcal AS 
with AVA 0.3cms, normal EF, normal chambers, and all grafts are patent. She 
just had her left subclavian stent redone to improve LIMA flow. The problem 
is she is now totally calcified from valve through arch and LCCA is 
occluded just after the origin. Additionally, she now has a 1.5cm LUL 
nodule which lights up on PET. Surprisingly, her PFT is remarkably good but 
she always reminds me that she had a difficult post op course from a 
pulmonary standpoint.
Any thoughts besides the word NO?
Thanks ahead of time.
Mitch Lirtzman


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