[HSF] (no subject)

[Hgrmd at aol.com]

Tom,
  The CT shows circumferential root and arch calcification.   However, the 
distal ascending aorta has scattered plaquing only.  To me, it  appears that it 
would be reasonable safe to instrument and clamp the distal  ascending aorta.  
As for viability, I haven't done any studies as  yet.  Again, the TEE shows a 
heavily calcified pig valve with leaflets that  are immobile.  There was 3+ 
MR with no prolapse and a central jet.  On  the transgastric view, the LV was 
globally hypokinetic with walls of normal  thickness (I don't recall the 
dimensions, but it was definitely not LVH).   The transthoracic echo revealed a 27mm 
gradient.  
  If I did offer surgery, what studies for viability would you  recommend?  I 
suppose I could do a Persantine-Thallium or a PET.   Unfortunately, a PET has 
to be done as an outpatient due to billing  considerations.  As you know I'm 
sure, in patient PET scans are not paid by  Medicare.
Hal



************************************** See what's free at http://www.aol.com.