[HSF] The unresolved ascending aorta.

[erdinç naseri]

Prasanna,
I got the pictures  but unfortunately was unable to see them.probably the echo soft ware is Mac based and this may be the reason.any how still have time till the operation and hopefully I will post them.
erdinc> To: OpenHeart-L at lists.hsforum.com> Subject: Re: [HSF] The unresolved ascending aorta.> Date: Mon, 11 Jun 2007 08:16:51 -0400> From: tdmartin2000 at aol.com> CC: > > Prasanna- The sinuses are 3.8cm and there is no AI as I  understand it. I would bet that the annulus is less than or equal to 25mm and as such the point of replacing the ascending is to prevent continued dilation and dissection. By replacing the ascending you would fix the sinotubular junction size and prevent any real chance of future AI. Further sinus dilation is possible but in my opinion and experience is probably not likely for a long time (> 10 yrs at 1 to 2 mm/yr at most or ever). As for results, I would expect any well trained thoracic surgeon who is capeable of repairing a mitral valve to be able to replace an ascending in this situation with little increased risk. > > Tom> > -----Original Message-----> From: prasannasimha <prasannasimha at gmail.com>> To: OpenHeart-L at lists.hsforum.com> Sent: Sat, 9 Jun 2007 8:06 pm> Subject: Re: [HSF] The unresolved ascending aorta.> > > Probably this is the danger of the "expert" opinion. His results/risk profile may not translate to the same result as others. So replacing the aorta may have different connotations and risks in the hands of different people. > Now the question - replace only the ascending aorta or do a David ? > Prasanna > tdmartin2000 at aol.com wrote: > > Ed > > > > It's not "if" it is when. In my opinion the risk of replacing the ascending now is far less than the risk of potential dissection and an emergency redo or even a redo sternotomy/ ascending repair in the future. I guess my opinions are jaded in that I see several pts a yr that come in with dissections or sig aneurysms that had previous operations anywhere from months to several yrs ago. Again, as I said on an earlier post - fix it now or fix it later- but someone will fix it unless the pt dies of their dissection first. > > > > Tom Martin > > U of Florida > > Gainesville > > > > > > -----Original Message----- > > From: Edward Bender <ebender001 at charter.net> > > To: OpenHeart-L at lists.hsforum.com > > Sent: Thu, 7 Jun 2007 10:02 pm > > Subject: Re: [HSF] The unresolved ascending aorta. > > > > > > > > Mike: > Sorry for being so terse. In the absence of bicuspid aortic valve with valvular pathology requiring replacement, I would not do an aortic operation. Isolated mitral valve repair would not increase the risks should she need aortic replacement in the future. > > Ed Bender, MD > > On Jun 7, 2007, at 7:55 PM, Michael Firstenberg wrote: > > >> Ed >> So you would leave it alone? >> >> michael >> >> Michael Firstenberg <msfirst at gmail.com> >> >> -----Original Message----- >> From: "Edward Bender" <ebender001 at charter.net> >> To: OpenHeart-L at lists.hsforum.com >> Sent: 6/7/2007 8:02 PM >> Subject: Re: [HSF] The unresolved ascending aorta. >> >> Meddlesome. >> >> Ed Bender, MD >> >> On Jun 7, 2007, at 6:18 PM, Michael Firstenberg wrote: >> >> >>> I was just referred a healthy 54 year/old who was found to have >>> moderated MR >>> from a prolopsed posterior leaflet - ok, will fix that. >>> But, on a MRA she was found to an asc. aneurysm (3.8 cm at the >>> Sinus of >>> valsalva) and 4.0cm a the level of the PA with a normal arch (the >>> studies >>> done do not comment on the aortic valve) >>> Obviously she needs a cath, but I am inclined to fix the ascending >>> aorta >>> while in there? I do not know her BSA, but I dont think she is big >>> >>> >>> >>> thoughts? >>> >>> >>> >>> -michael >>> _______________________________________________ >>> OpenHeart-L mailing list >>> >>> Send postings to: >>> OpenHeart-L at lists.hsforum.com >>> >>> To UNSUBSCRIBE, to CHANGE email address, or to view archives: >>> http://mmp.cjp.com/mailman/listinfo/openheart-l >>> >>> All messages transmitted by the OpenHeart-L are subject to the >>> policies and disclaimers posted at: >>> http://www.hsforum.com/listdisclaim >>> ----------------------------------------- >>> >> >> _______________________________________________ >> OpenHeart-L mailing list >> >> Send postings to: >> OpenHeart-L at lists.hsforum.com >> >> To UNSUBSCRIBE, to CHANGE email address, or to view archives: >> http://mmp.cjp.com/mailman/listinfo/openheart-l >> >> All messages transmitted by the OpenHeart-L are subject to the > policies and >> disclaimers posted at: >> http://www.hsforum.com/listdisclaim >> ----------------------------------------- >> >> _______________________________________________ >> OpenHeart-L mailing list >> >> Send postings to: >> OpenHeart-L at lists.hsforum.com >> >> To UNSUBSCRIBE, to CHANGE email address, or to view archives: >> http://mmp.cjp.com/mailman/listinfo/openheart-l >> >> All messages transmitted by the OpenHeart-L are subject to the > policies and >> disclaimers posted at: >> http://www.hsforum.com/listdisclaim >> ----------------------------------------- >> > > _______________________________________________ > OpenHeart-L mailing list > > Send postings to: > OpenHeart-L at lists.hsforum.com > > To UNSUBSCRIBE, to CHANGE email address, or to view archives: > http://mmp.cjp.com/mailman/listinfo/openheart-l > > All messages transmitted by the OpenHeart-L are subject to the policies anddisclaimers posted at: > http://www.hsforum.com/listdisclaim > ----------------------------------------- > > > > > ________________________________________________________________________ > > AOL now offers free email to everyone. Find out more about what's free from AOL at AOL.com. > > _______________________________________________ > > OpenHeart-L mailing list > > > > Send postings to: > > OpenHeart-L at lists.hsforum.com > > > > To UNSUBSCRIBE, to CHANGE email address, or to view archives: > > http://mmp.cjp.com/mailman/listinfo/openheart-l > > > > All messages transmitted by the OpenHeart-L are subject to the policies and > disclaimers posted at: > > http://www.hsforum.com/listdisclaim > > ----------------------------------------- > > > > > >  > _______________________________________________ > OpenHeart-L mailing list >  > Send postings to: > OpenHeart-L at lists.hsforum.com >  > To UNSUBSCRIBE, to CHANGE email address, or to view archives: > http://mmp.cjp.com/mailman/listinfo/openheart-l >  > All messages transmitted by the OpenHeart-L are subject to the policies and disclaimers posted at: > http://www.hsforum.com/listdisclaim > ----------------------------------------- > > > ________________________________________________________________________> AOL now offers free email to everyone. Find out more about what's free from AOL at AOL.com.> _______________________________________________> OpenHeart-L mailing list> > Send postings to:> OpenHeart-L at lists.hsforum.com> > To UNSUBSCRIBE, to CHANGE email address, or to view archives:> http://mmp.cjp.com/mailman/listinfo/openheart-l> > All messages transmitted by the OpenHeart-L are subject to the policies and > disclaimers posted at:> http://www.hsforum.com/listdisclaim> -----------------------------------------