[HSF] Calcified aortic stenosis

[Hgrmd at aol.com]

Mitch,
  Your fears about risk of stroke with transapical aortic valve  insertion 
are understandable, but unrealized from what I've seen in the  presentations to 
date.  Go to the meetings and hear the talks before you  dismiss it as having 
a prohibitive stroke rate.  Anyway, the point is moot  since access to the 
procedure is still very tightly controlled.
  If the patient doesn't have significant AI, I would favor the aortic  valve 
bypass and concomitant wedge resection of the presumed malignancy.   You 
shouldn't need to stage lysis of adhesions and the actual procedures.   I'm 
currently working up an 89 yo with a similar root.  If her coronaries  can be fixed 
with PCI, then I plan to do an apical conduit in about 3  weeks.
  Have a nice vacation.
 
Hal



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