[HSF] Rheumatic mitral valve

[A]

Dear Ed:
What is the LA size any TR? Coronaries clean? With pure MS no regurgitation
a commisurotomy is all what you probably need to do. 
Just wondering if the coronaries are clean and no evidence of clots our
cardiologists would not refer such patients to surgery they will try
percutaneous valvotomy. Wish you luck I am sure that she would do fine in
your hands.

Ahmed


-----Original Message-----
From: openheart-l-bounces at lists.hsforum.com
[mailto:openheart-l-bounces at lists.hsforum.com] On Behalf Of Edward Bender
Sent: Tuesday, June 26, 2007 8:28 PM
To: OpenHeart-L
Subject: [HSF] Rheumatic mitral valve

I have a 70 year old female with paroxysmal a-fib and mitral stenosis  
from rheumatic fever as a child.  I plan a maze procedure and mitral  
repair.  By TEE I am convinced that she can be treated with mitral  
commisurotomies.  She has very little calcification and no  
regurgitation at all.  The patient has class 2 symptoms and good LV  
function, but she is really bothered by the repeated bouts of a-fib.   
My question is whether, upon repairing the valve, she should have a  
ring to support her annulus.  We rarely get to do these procedures in  
the USA, so I wonder what the current thinking is.

Ed Bender, MD
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