[HSF] Rheumatic mitral valve

[erdinç naseri]

Prasanna,
LA body clot per se is an indication for surgery but MS in NYHA class II( MVA?, transvalvular gradient?)is a debatable issue.
erdinc
> Date: Wed, 27 Jun 2007 19:20:05 +0530> From: prasannasimha at gmail.com> To: OpenHeart-L at lists.hsforum.com> Subject: Re: [HSF] Rheumatic mitral valve> CC: > > Tell that to a cardiologist !!> We have them doing balloons for MS in afib with LA appendage clots and> even body clots with anticoagulation for 2-3 months. At one time these> were indications for emergent study today it is acceptable for a person> to wait 6 weeks on Coumadin - shifting goals and indications !!(To suit> themselves).> Indications for commissurotomy is a pliant valve with an LA body clot or> some other reason for which balloon is not possible. Replacement is> basically indicated for commissurotomy failure or calcified valve or> extreme subvalvar crowding that cannot be relieved.> Personally I feel the ultimate indication for surgery is a case with LA> body clot. Doing a maze in these patients with ultimate "atrial failure"> still allows around 70 % to achieve a sinus rhythm which with an OMV> could mean freedom from anticoagulation with allits morbidity.I have> currently 62 such patients (since 97) with large body clots who have> undergone OMV with emaze. I have sent pictures of some of these huge> clots from time to time.> Prasanna> > Tohru Asai wrote:> > Hal, Prasanna, Ahmed, Ed> >> > Symptomatic pAF associated with rheumatic MS may not be a good candidate for> > cathter-based AF ablation. A friend of mine (EP cardiologist) once talked to> > me. Ed's cardiologists may expect perfect maze with mitral surgery. Am I> > wrong?> >> > I would do OMC without ring plus RF maze.> >> > BTW any member tell me what is current indication of commissurotomy vs> > replacement for rheumatic MS?> >> > > _______________________________________________> 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> -----------------------------------------