[HSF] rheumatoid arthritis+ root dilatation

[erdinç naseri]

Dear Dr. Martin,
1.WRT felt I may have used an inappropriate term: a piece of the graft used for ascending aorta
2.RC ostium was at top of the commisure and it was "impossible to prepare even a small button without sacrifying the RCC-NCC commisure.What is th ebest surgical plan in a situation like this?
erdinc> To: OpenHeart-L at lists.hsforum.com> Subject: Re: [HSF] rheumatoid arthritis+ root dilatation> Date: Thu, 21 Jun 2007 22:30:37 -0400> From: tdmartin2000 at aol.com> CC: > > Sounds reasonable except for reinforcement with felt. Felt doesn't hold it's strength very long and will dilate readily. I have reoperated on 1 pt whose aorta was wrapped in felt for the treatment of small aneurysms. It doesn't prevent aneurysm formation and is really difficult to deal with on reop. I instead would have considered replacing the sinus with dacron graft material. A valve salvage procedure with abnormally placed coronaries can be difficult and in your situation you can usually just have a really small button for the right. > > Tom Martin> U of Florida> Gainesville> > > -----Original Message-----> From: erdinç naseri <enaseri at hotmail.com.tr>> To: openheart-l at lists.hsforum.com> Sent: Thu, 21 Jun 2007 4:13 pm> Subject: [HSF] rheumatoid arthritis+ root dilatation> > > > > ear verybody,> oday I operated the lady.> .Preop plan:either supracoronary graft replacement or root reimplantation.> .Intraop observation:anulus 25 mm sizer,STJ 31 sizer,terminal asc.aorta> 33 > izer.Intented to perform root reimplantation but R coronary ostium just left > ide of NCC-RCC commisure and extend on top of it .Couldn't figure out how to > repare aortic button and cusp scallops > .Op:teflon felt enhancement of NCC from outside the aortic wall+ ascending and > rox arch replacement.No AI with 10 cm of water inside the graft.> ny comment regarding 2.> rdinc>> ______________________________________________> penHeart-L mailing list> Send postings to:> OpenHeart-L at lists.hsforum.com> To UNSUBSCRIBE, to CHANGE email address, or to view archives:> ttp://mmp.cjp.com/mailman/listinfo/openheart-l> All messages transmitted by the OpenHeart-L are subject to the policies and > isclaimers posted at:> ttp://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> -----------------------------------------