[HSF] Tricuspid repair w/pulmonary hypertension

[erdinç naseri]

completely agree with Don.TR + PAP 90 mmhg in CAD is an absolute 
contraindication for CABG.It will not improve survival and QOL and it will 
risk the patient for a high operative mortality.
erdinc



>From: Donald Ross <donross at bigpond.com>
>Reply-To: OpenHeart-L at lists.hsforum.com
>To: OpenHeart-L at lists.hsforum.com
>Subject: Re: [HSF] Tricuspid repair w/pulmonary hypertension
>Date: Thu, 1 Mar 2007 17:08:59 +1100
>
>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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