AW: AW: AW: [HSF] Video of the week

[Ani Anyanwu]

Dr Flege - what was your reason for preferring to do these on CPB?
 
Prassana and others - what is your reason for preferring not to do them on bypass. Is it a cost thing, macho thing, or just that CPB is unnecessary. I must say in many parts of Africa these are done without bypass even available for back-up but what that means is a higher mortality risk if major cardiac injury.
 
I think though that deciding to shift to CPB because of tricuspid repair is not the whole story and there may be other reasons other than tricuspid alone that made the leipzig group switch (Roberto ???)
 
Ani
 



> From: Jbflegejr at aol.com> Date: Tue, 9 Oct 2007 13:41:10 -0400> Subject: Re: AW: AW: AW: [HSF] Video of the week> To: OpenHeart-L at lists.hsforum.com> CC: > > As I recall, patients who had longstanding constrictive pericarditis usually > had biventricular dilatation after pericardiectomy and usually this receded in > time but not always. I attributed this to loss of ventricular diastolic tone > while the heart was supported by the pericardium. We were not attuned to the > possibility of tricuspid insufficiency which may have been a reason why some > patients never made a good recovery. I can see why there could be no TI at the > end of operation and then have it develop as the RV dilated. Usually the > physicians following these patients, most not cardiologists, may not recognize TI > and if the patient is improved after operation are satisfied, and same for the > patient, and may not be motivated to look for a reason why the patient is not > even better. I suppose one lesson to come away with is to keep in mind the > possibility of late TI and act accordingly. Doing an annuloplasty at the time of > pericardiectomy does not seem unreasonable and if one uses CPB for the > pericardiectomy as I did, annuloplasty would not add very much to the procedure. John > Flege> > > > ************************************** See what's new at http://www.aol.com> _______________________________________________> 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> -----------------------------------------
_________________________________________________________________
The next generation of MSN Hotmail has arrived - Windows Live Hotmail
http://www.newhotmail.co.uk