[HSF] Calcified aortic stenosis

[Salerno, Tomas]

No. Matter how, these are challenging and risky (CNS) cases. Good luick

Tomas



----- Original Message -----
From: openheart-l-bounces at lists.hsforum.com <openheart-l-bounces at lists.hsforum.com>
To: OpenHeart-L at lists.hsforum.com <OpenHeart-L at lists.hsforum.com>
Sent: Sun Jul 01 23:43:23 2007
Subject: RE: [HSF] Calcified aortic stenosis

Dr. Salerno, I looked very closely at the CT and the valve/ascending/arch 
are one continuous white ring. I agree with Hal that axillary cannulation 
would be doable, though now I'm really considering an apical conduit, too. 
I'll report back on the rest of her work-up.
MItchAt 10:30 AM 7/1/2007, you wrote:
>I have done three of such patients with porcelain aortas in the last few 
>yearas. In each case, I was able to find a place in the distal aorta to 
>cannulate, and a soft spot where a cross-clamp could be applied after 
>systemic flow was decreased.  None of the patients had neurological 
>problems after surgery, although the operation was rather tedious.
>
>
>Tomas
>
>-----Original Message-----
>From: openheart-l-bounces at lists.hsforum.com 
>[mailto:openheart-l-bounces at lists.hsforum.com] On Behalf Of jbflegejr at aol.com
>Sent: Sunday, July 01, 2007 9:33 AM
>To: OpenHeart-L at lists.hsforum.com
>Subject: Re: [HSF] Calcified aortic stenosis
>
>Apico-aortic conduit is one possibility. Another could be hypothermic
>circulatory arrest and replace the valve while arrested, or replace the
>ascending aorta, clamp the graft and resume circulation and then
>replace the valve. John Flege
>
>
>-----Original Message-----
>From: Mitch Lirtzman <drmitch at cox.net>
>To: OpenHeart-L at hsforum.com
>Sent: Sat, 30 Jun 2007 7:48 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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