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

[Tea Acuff]

Sooner or later you have to try and separate them if there is actually a baby in that bath water, eg they are separable. 
tea


----- Original Message ----
From: prasannasimha <prasannasimha at gmail.com>
To: OpenHeart-L at lists.hsforum.com
Sent: Thursday, July 12, 2007 8:56:20 PM
Subject: Re: [??????????????]Re: [HSF] Posterior Post-Infarction VSD, SAM, and other Misery


Isn't that throwing the baby with the bathwater ?
prasanna
Tea Acuff wrote:
> 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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