[??????????????]Re: [HSF] Posterior Post-Infarction VSD, SAM, and other Misery

[Tea Acuff]

Exactly what led me a decade or so ago to largely abandon and certainly disprove the dictum to use rings for every repair.
tea


----- Original Message ----
From: Ajit Damle <damle at cableone.net>
To: OpenHeart-L at lists.hsforum.com
Sent: Thursday, July 12, 2007 5:43:23 PM
Subject: RE: [??????????????]Re: [HSF] Posterior Post-Infarction VSD, SAM, and other Misery


I had one such a case. Post-repair that was a single narrow jet, seen only
in one view that was against a portion of Duran ring. Anemia stabilized at
8.5 gms. I ended up replacing the valve.

Ajit Damle

-----Original Message-----
From: openheart-l-bounces at lists.hsforum.com
[mailto:openheart-l-bounces at lists.hsforum.com] On Behalf Of ??
Sent: Thursday, July 12, 2007 5:34 PM
To: OpenHeart-L at lists.hsforum.com
Subject: Re: [??????????????]Re: [HSF] Posterior Post-Infarction VSD, SAM,
and other Misery

Dear Members, I would like to have your thoughts about the following case.

57 male had severe MR ( 4+) from mitral posterior leaflet prolapes, And
received mitral repair ( Q resection of the posteroir leaflet and 29# ring
( O shape ), TEE showed 1 one +  MR during surgery. He had uneventful
recovery and went home. Three weeks after surgery, he had jaundice and
hemolysis with elevated hepatic enzyme. HCT went down from 40 to 30%. Even
after 6 weeks medical treatment, his jaundice getting better and hepatic
enzyme went down too, but not normal yet. We checked echo again it shows
that the size of LA and LV is smaller that that before surgery, and have +
to ++ MR, with a II/6 systolic murmer. EF is normal. Now he is about 3
months after. 

Is his jaundice and hemolysis related to the ring or repair? Should we do
anything surgically? Replacememt of the mitral valve? or wait? or other? 

Many thanks in advance for your help. 

Steve 

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