[HSF] AI and ASC AO Aneurysm s/p Ross procedure

[Salerno, Tomas]

It will be somewhat difficult. Someone needs to put some sense into the
patient to accept a mechanical prosthesis. This should be his last
operation, despite the need for anticoagulation.

Tomas

-----Original Message-----
From: openheart-l-bounces at lists.hsforum.com
[mailto:openheart-l-bounces at lists.hsforum.com] On Behalf Of
Cysmd613 at aol.com
Sent: Thursday, September 06, 2007 1:01 AM
To: OpenHeart-L at lists.hsforum.com
Subject: [HSF] AI and ASC AO Aneurysm s/p Ross procedure

I would like to get the Forum's opinions and advice concerning an
interesting 
patient referred to me.
 
44 yo male who underwent Ross Procedure in 1995 (pulmonary homograft
used to 
replace PV and prox PA) for a 6cm ascending aortic aneurysm and bicuspid

aortic valve.  According to the op report, he did not have AI pre op.  
Recently he has been having some dyspnea on exertion and decreased
stamina 
(he used to surf for 4 to 5 hours a day, now he can only last about 1.5
hours).  
An echo showed moderate to severe AI, a 5.5 cm aortic root, and a
significant 
gradient across the pulmonic valve.
Appears that he needs redo aortic root replacement and pulmonic valve 
replacement.
In your experience, how difficult is the dissection after a Ross
procedure, 
as I haven't had the pleasure of operating on a patient who has had a
prior 
Ross.  
This patient does not wish a mechanical valve, so I would plan to use 
pericardial valves.
 
Thank you in advance for your responses.
 
Carmi Stadlan



************************************** Get a sneak peek of the all-new
AOL at 
http://discover.aol.com/memed/aolcom30tour
_______________________________________________
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
-----------------------------------------