AW: [HSF] IE

[erdinç naseri]

Roberto,
Aportic annulus was completely clean .As I said it was quadricuspid with a 
rudimentary cusp between RCC and NCC.and RCC was dettached from the annulus 
in most of its length.
erdinc


>From: "Dr. Roberto Battellini" <battr at medizin.uni-leipzig.de>
>Reply-To: OpenHeart-L at lists.hsforum.com
>To: <OpenHeart-L at lists.hsforum.com>
>Subject: AW: [HSF] IE
>Date: Fri, 16 Mar 2007 15:29:15 +0100
>
>Erdinc,
>congratulations for   the case, hard case. You did what a surgeon must do.
>Was the aortic annulus able to be sutured?
>I had a similar case in an older patient
>last year, the aortic annulus was totally an abscess, and after cleaning
>everything I had to put a big pericardial patch in the septum and a
>Freestyle in the patch, but he died.
>Roberto
>
>-----Ursprüngliche Nachricht-----
>Von: openheart-l-bounces at lists.hsforum.com
>[mailto:openheart-l-bounces at lists.hsforum.com] Im Auftrag von erdinç naseri
>Gesendet: Freitag, 16. März 2007 12:21
>An: OpenHeart-L at lists.hsforum.com
>Betreff: [HSF] IE
>
>
>Would like forum's opinion ( retrospectively):
>35 y/o male,4 years ago MVR,2 months ago diagnosed as S.aureus IE(
>vegetations on TEE) and treated medically and dissmissed as cured( another
>center). admitted to our center 2 weeks ago in HF and rapidly decompensated
>and intubated.TEE probe out of use ( broken), TTE showed AI+TI both severe
>Prosthhetic mitral ?,no fever no organism on blood culture ,High hepatic
>enzymes ,good renal function.Had multiple toe infartcts,splenic infarct on
>CT,2 mid size brain infarcts ( neurologists said would recover).I saw the
>patint inICU incidentally yesterday morning.Unconscious on dormicum and
>fentanyl(slight eye brow movement on painful stimuli)Cardiologist idea was
>that this was not recurrent IE but I thought that was obvious.( 
>disscussions
>
>of minor and major criteria and that the patient did not fit in them).On
>evening  while leaving the hospital I observed that the patient was
>anuric.Talked to cardiologists and took the patient to OR.
>OP:Quadricusp aortic valve with complete  dehiscence of the RCC, Huge
>vegetation on mitral prosthesis and severe TI.No need to cut the sutures of
>Prosthesis .Just took  the ring and with mild traction it was dehisced from
>the annulus half the way to posterior rim bilaterally.Agressive debriment 
>of
>
>annulus and AVR + Re MVR+ DeVega.
>Today stable hemodynamically and started opening eyes
>erdinc
>
>
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