(OT)Re: [HSF] Rheumatic mitral valve

Sat Jun 30 11:22:15 EDT 2007

I thought 2 of them were inhibitory!

>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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>_______________________________________________
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-- 
Ben Bidstrup FRACS FRCSEd FEBCTS
Consultant Cardiothoracic Surgeon