[HSF] Cardiac Amyloidosis

[Nasser F. Abou'Seada]

An awesome attitude, setting an example, that makes one think and
realize the real meaning of a professorship. Cordial Regards.

NFA


On 5/31/07, Salerno, Tomas <TSalerno at med.miami.edu> wrote:
>
> The one aspect of my life that I have enjoyed is to see my former fellows
> who have grown into cardiac surgeons, and who have developed independent
> thinking. Best, Michael.
>
>
> Tomas
>
> ________________________________
>
> From: openheart-l-bounces at lists.hsforum.com on behalf of Crittenden,
> Michael
> Sent: Thu 5/31/2007 5:40 PM
> To: OpenHeart-L at lists.hsforum.com
> Subject: RE: [HSF] Cardiac Amyloidosis
>
>
>
> To John,
>
> This chap had his right and left heart caths done ~10 days ago.  He
> major symptoms were dyspnea although he did admit to some exertional
> angina.  The echo demonstrated left and right ventricular hypertrophy
> and his myocardium had a granular or speckled appearance which had been
> described in amyloidosis.  His left main disease was a surprise.
>
> He was sent home without a surgical consult while awaiting the biopsy
> report.  BEFORE the biopsy report came back, the patient was readmitted
> last Saturday through the ER with acute onset (10/10) retrosternal chest
> discomfort with some radiation to his throat.  That's when we were
> consulted.
>
> Biopsy reports came back yesterday afternoon.  Now the cardiologists
> want to know what we want to do.
>
> Usually this kind of patient would have been done fairly soon post cath
> but the (potential) amyloid was a red herring.
>
> Although this case may not be an emergency, doesn't a symptomatic
> patient with an ostial 60-70% Left main with depressed LV function
> warrant surgery.
>
>
>
> To Tomas--my former professor,
>
> I know I will hear your voice gently chastising me as I clamp this man's
> aorta.  Wish me some luck.
>
>
> Mike
>
>
>
>
> -----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: Thursday, May 31, 2007 10:47 AM
> To: OpenHeart-L at lists.hsforum.com
> Subject: Re: [HSF] Cardiac Amyloidosis
>
> Properly managed, the myocardium should come through CPB nicely. You
> haven't
> asked the most relevant question: does this patient need an operation
> and
> could an operation be expected to improve his situation?
> John Flege
>
>
>
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> http://www.aol.com <http://www.aol.com/> .
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-- 
Nasser  F.  Abou'Seada,
MB,ChB,MD,FRCSEd,ChM,ChD C/Th,
FICS,FISCVS,FSSRCTS,FHMS,MESC