AW: [HSF] Correction of MR in Myopathic Ventricles

[Tea Acuff]

Roberto's point is that CMR is the most reliable and repeatable way to measure EF, or what is actually measured, the ESV and EDS by multiple short axis volume reconstructions. In an asynchronous heart the  LV "wobbles" so measuring the whole LV in one planar frame is actually impossible. One part is contracting while another is expanding. Echo's as we know from intraop TEE are also extremely variable. Severe TR may completely disappear as some have mentioned. 
It is like our EBM. Even if it is a honest measurement (or a real p value), if it is crap it likely means crap. It just becomes Class I evidence crap. (Well maybe this wasn't exactly what Roberto meant!)
tea


----- Original Message ----
From: Dr. Roberto Battellini <battr at medizin.uni-leipzig.de>
To: OpenHeart-L at lists.hsforum.com
Sent: Wednesday, March 7, 2007 2:46:32 PM
Subject: AW: [HSF] Correction of MR in Myopathic Ventricles


It´s unbelievable! Do you have MRI´s?
Roberto

-----Ursprüngliche Nachricht-----
Von: openheart-l-bounces at lists.hsforum.com
[mailto:openheart-l-bounces at lists.hsforum.com] Im Auftrag von hgrmd at aol.com
Gesendet: Mittwoch, 7. März 2007 17:16
An: OpenHeart-L at lists.hsforum.com
Betreff: [HSF] Correction of MR in Myopathic Ventricles

Dear Members,
  I just saw a morbidly obese 58 yo lady in my office for followup.  In
September '05, she presented with multiple hospitalizations for CHF.  She
had normal coronaries, severe MR, and an EF of 8% by planimetry on TEE!  I
did mitral and tricuspid repairs.  A few days later, she had a biventricular
pacer inserted.  
  Since then, she has been readmitted only once for a TIA.  She is
completely asymptomatic.  Transthoracic echo from last month revealed trace
MR, no TR, and an EF of 50-55%.  My belief is that most surgeons wouldn't
have touched her with a ten foot pole.  Comments?

Hal
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