[HSF] Tricuspid repair w/pulmonary hypertension

[Donald Ross]

I think TR in this setting is a symptom of an inoperable disease and  
repair only hastens inevitable demise.
I speak from bitter experience by the way!
Don
On 01/03/2007, at 3:18 PM, James S Gammie wrote:

> HSF:
> elderly male 3vCAD, ef 50 %, severe mr (type I-dilated annulus),  
> severe TR, PA pressures systolic 90.
>
> operation:
> CABGx4, 28 physio for mitral, 26 mc3 for tricuspid;
>
> postpump tee: no mr, no tr, good lv function.  RV sick; unable to  
> wean cpb despite usual measures: RVAD outcome uncertain.
>
> Qs:  any reservations about correcting TR in face of near systemic  
> pulm htn?
>        any role for assessing "reversibility" of pulmonary vascular  
> resistance, like we do in transplant?
>        what is forum's experience with outcomes for mv/tv ops in  
> patients with similar PA pressures?  Literature suggests up front  
> mort of 10-15 percent but fairly old experience...
>
> jsg
>
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