(OT)Re: [HSF] Rheumatic mitral valve

Fri Jun 29 16:55:59 EDT 2007

surely you jest! All three of my connected neurons are moving my fingers and planning the next move...I'm in the performance "flow" like a 79 yo with prostatism...
tea

----- Original Message ----
From: prasannasimha <prasannasimha at gmail.com>
To: OpenHeart-L at lists.hsforum.com
Sent: Friday, June 29, 2007 8:09:32 AM
Subject: (OT)Re: [HSF] Rheumatic mitral valve

I become rather nonverbal during surgery

To quote Hal - Huh ?
Prasanna

Tea Acuff wrote:
> I was working today at our new heart hospital with a scrub that never worked with me before. Although we both knew the general direction the operation was going, I was a little unclear of what was available and the scrub was a little unclear of what I wanted. I become rather nonverbal during surgery, so my PA offered this description to the scrub of want we were doing, "We follow standard procedure except if it seems unnecessary." 
> An entirely subjective statement, but a clue as to how we planned to arrive at our destination.
>
> I agree that CPB is often unnecessary. Often so is a ring. We on HSF just disagree widely as to the definiton of "often".
>
> tea
>
>
> ----- Original Message ----
> From: Igor Rudez <rudi at kbd.hr>
> To: OpenHeart-L at lists.hsforum.com
> Sent: Thursday, June 28, 2007 1:09:50 AM
> Subject: RE: [HSF] Rheumatic mitral valve
>
>
> Tea, 
> FYI I do 100% OPCABs. And I rest my case!
> ;-)
>
> Igor
>
> -----Original Message-----
> From: openheart-l-bounces at lists.hsforum.com
> [mailto:openheart-l-bounces at lists.hsforum.com] On Behalf Of Tea Acuff
> Sent: Wednesday, June 27, 2007 7:22 PM
> To: OpenHeart-L at lists.hsforum.com
> Subject: Re: [HSF] Rheumatic mitral valve
>
>
> I don't know Igor. By that logic why do off pump CAB, open commisurotomy or
> mitral valve repair at all if you had "success" otherwise before? tea
>
>
> ----- Original Message ----
> From: Igor Rudez <rudi at kbd.hr>
> To: OpenHeart-L at lists.hsforum.com
> Sent: Wednesday, June 27, 2007 4:06:31 AM
> Subject: RE: [HSF] Rheumatic mitral valve
>
>
> Dear Ed,
> I think that not only commisurotomy is needed. You might also need to resect
> some of the secondary cordae of the posterior leaflet and you might also
> need to enlarge posterior leaflet with a patch of pericardium! I allways put
> a ring (why not?) at the end of the procedure! This is how I was taught by
> Robert Dion. It works, so why change winning combination!
>
> Igor Rudez
>
> -----Original Message-----
> From: openheart-l-bounces at lists.hsforum.com
> [mailto:openheart-l-bounces at lists.hsforum.com] On Behalf Of A
> Sent: Wednesday, June 27, 2007 7:15 PM
> To: OpenHeart-L at lists.hsforum.com; 'OpenHeart-L'
> Subject: RE: [HSF] Rheumatic mitral valve
>
>
> 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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