[HSF] Severe AS in a frail male patient

[erdinç naseri]

Dear Dr. Bidstrup,
Do you mean volume reducing lung surgery or is there any other way to decrease the lung volume.
erdinc> Date: Mon, 10 Sep 2007 13:57:05 +1000> To: OpenHeart-L at lists.hsforum.com> From: benjamin.bidstrup at bigpond.com> Subject: RE: [HSF] Severe AS in a frail male patient> CC: > > In patients like these, I defy the cardiologist's > desire to operate yesterday and send at least 4 > if not more weeks getting the lungs right. I use > a programmes based on the lung volume reduction. > Optimize bronchodilator, inhaled steroids and > other agents, exercise and regular measurements > of peak flow or FEV1.> > Antibiotics if indicated.> > The extra time is well worth it.> > >I have done 2 AVR`s on patients with bronchiectasis,> >and both never came off the ventilator.> >> >I am sure you can buy enough time to get him into a> >better condition, and further check out his lung> >condition. Does he have an active lung infection now?> >TB? What is the CRP? What is the FEV1? If it is less> >than 40%, with bronchiectasis, you are not likely to> >get him off the ventilator, so I would spare your> >resources, and if your waiting lists are like they are> >in the state hospitals in S Africa then why not triage> >and give the OR list to the other, probably almost as> >sick patient that has been waiting almost a year, and> >is about to fall off the perch?> >> >Dave Harris> >--- erdinç naseri <enaseri at hotmail.com.tr> wrote:> >> >>> >> Dear Dr.Zhou,> >> Though I did only 3 cases of minimally invasive AVR> >> throughout my carrier ,my main concern is the> >> detrimental effects of open heart surgery on> >> noncardiac organs of this gentelman.> >> erdinc> From: zzhoumd at pol.net> To:> >> OpenHeart-L at lists.hsforum.com> Subject: Re: [HSF]> >> Severe AS in a frail male patient> Date: Fri, 7 Sep> >> 2007 13:09:35 -0400> CC: > > Can you do a mini> >> invasive valve replacement?> > Z Zhou> > -----> >> Original Message ----- > From: "psimha"> >> <prasannasimha at gmail.com>> To:> >> <OpenHeart-L at lists.hsforum.com>> Sent: Friday,> >> September 07, 2007 8:09 AM> Subject: Re: [HSF]> >> Severe AS in a frail male patient> > > Erdinc , you> >> have a cruel referring cardiologist !!> You may have> >> to do a bioprosthetic AVR as he has h/o hemoptysis.> >> If you > need to do it quick in and out and the> >> minimal necessary surgery.> Prasanna> erdinç naseri> >> wrote:> > Opinion requested:> > 73 Y/O male very> >> frail .Admitted with dyspnea and effort intolerance(> >> can't walk witout help),gave a history of> >> hemoptysis> > CXR: increased broncovascular> >> markings,CM,calcification of aortic root very> >> clearly seen> > Chest CT:bronchiectasis,severe> >> calcification of aortic valve> > ECG:LVH> > Echo:EF(> >> sim> >> pson's) 25%,Aortic gradient 90 mmHg,AR+++,(> >> leaflets mobility very decreased),MR++> >> >> CAG:previously stented LAD open> > Cre:2.1 mgr/dl> >> >> > > treated for lung condition and now it is our> >> turn.I have got the impression that he won't survive> >> the operation.> > erdinc > > > > > > > >> >> _______________________________________________> >> >> 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> >> >> -----------------------------------------> >> >> > >> >> > > _______________________________________________>> >> 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>> >> -----------------------------------------> >> _______________________________________________> >> 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> > > -----------------------------------------> >>> >> >> >Dr. David G. Harris, FCS, MMED,> >Cardiothoracic Surgeon > >Suite 207 > >Kuils River Private Hospital, > >PO Box 1200, Kuils River, 7579, Cape Town, South Africa. > >Tel +27-21-9006411 > >Fax +27-21-9006412 Mobile +27-83-3309587> >> >_______________________________________________> >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> >-----------------------------------------> > > -- > Ben Bidstrup FRACS FRCSEd FEBCTS> Consultant Cardiothoracic Surgeon> _______________________________________________> 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> -----------------------------------------