[HSF] Another on vs off pump question......

[murtaza chishti]

couple questions:

how much myocardium is left in LAD territory?

where exactly is the lung mass? likely nature of it?

What is the reason for TR?

Status of deep leg Veins?

murtaza chishti



























>From: "Michael Firstenberg" <msfirst at gmail.com>
>Reply-To: OpenHeart-L at lists.hsforum.com
>To: OpenHeart-L at lists.hsforum.com
>Subject: [HSF] Another on vs off pump question......
>Date: Mon, 14 May 2007 20:30:01 -0400
>
>Just got a call from my friendly interventionalist.
>
>72 year/old, multiple medical problems (nothing too bad), but has a "lung
>mass" which may need work-up and treatment - so he really does not want to
>put a proximal LAD stent in and keep her on Plavix forever.  He asked me to
>do an off-pump LIMA to LAD.  Sounds good.  However, since her admission
>diagnosis was a anterior wall MI, we are letting her "cool down" (peak
>troponin 500 - yikes).  So we got an echo to eval function.  EF~30%, little
>AI, little MR, moderate TR, elevated pulmonary pressures..... ok nothing 
>too
>bad.  Small PFO.
>
>Question: 1)  Off-pump LIMA-LAD and ignore the PFO
>               2)  On-pump LIMA-LAD and close the PFO
>               3)  Would anyone touch the tricuspid (sorry dont have the
>sizes)
>               4)   Let him put in a BMS and a clam-shell to the PFO and
>walk away..........
>
>
>Hate to go on pump just to fix a PFO - but she may get a lung resection at
>some point and she already does have some pulm hypertension.
>
>----thoughts/comments?
>
>
>
>-michael
>_______________________________________________
>OpenHeart-L mailing list
>
>Send postings to:
>OpenHeart-L at lists.hsforum.com
>
>To UNSUBSCRIBE, to CHANGE email address, or to view archives:
>http://mmp.cjp.com/mailman/listinfo/openheart-l
>
>All messages transmitted by the OpenHeart-L are subject to the policies and 
>disclaimers posted at:
>http://www.hsforum.com/listdisclaim
>-----------------------------------------

_________________________________________________________________
Spice up your IM conversations. New, colorful and animated emoticons. Get 
chatting! http://server1.msn.co.in/SP05/emoticons/