[HSF] tricuspid noncoaptation

[Nasser F. Abou'Seada]

That sounds great Prasanna .... please elaborate more about your experience
in inserting these indigenous rings in the tricuspid ... any complications ?
you actually fix the sutures to the septal leaflet at the AVN dangerous area
? ....

NFA

On Feb 13, 2008 7:32 PM, Prasanna Simha M <prasannasimha at gmail.com> wrote:

> Nasser , you can make the Goretex steel ring and place it with the base on
> the septal leaflet and since it is a complete ring , place the septal
> sutures in the area of the AV node on the septal leaflet like in a VSD.
> That
> is what I do. I am happy with it.
> Prasanna
>
> On Feb 14, 2008 6:12 AM, Nasser F. Abou'Seada <nfaabouseada at gmail.com>
> wrote:
>
> > Welcome Dave ...
> > who would pay for your private patients if the insurrence is not ?? ...
> > what
> > would you do if the "pay" is NOT inclusive of the ring ???
> > what if the insurance is NOT paying cause the tricuspid is DEFINITELY
> not
> > incomptent at the time of the operation as indicated by TTE, TEE,
> > Epicardial ?? ... still the patient had a history of previous TR ??
> > indicating the "readiness" of the tricuspid annulus to dilate ? .. as in
> > this case ??
> >
> > it is NOT a case of whichever technique is superior ... rather whichever
> > technique is FEASIBLE .... especially when no one is paying ....
> > Prasanna ... what about his indigenous mitral rings ???? ........... no
> > one
> > is comparing Prasanna's "ingenious indigenous" rings to other rings ...
> > performance wise .... but rather ..COST & FEASIBILITY -wise ...
> >
> > last point .. why a thoracotomy ?? giving the patient a new scar ???
> ....
> > first time redo ... or even more is not a problem ... especially when
> the
> > heart need not be mobilized .... just the right side .... on beating
> heart
> > .... !!!!
> >
> > nice to have heard of you ...
> >
> > NFA
> >
> > On Feb 13, 2008 1:58 PM, David Harris <drdharris at yahoo.co.uk> wrote:
> >
> > > I agree with you Hal. In this case definitely a ring.
> > > Do you think a De Vega will suffice in cases of
> > > trivial TR (at the time of mitral repair)?
> > >
> > > Also, what about a mini-thoracotomy approach in this
> > > patient. This will be the simplest approach,
> > > especially as one does not need to access or clamp the
> > > aorta.
> > >
> > > Dave
> > >
> > > --- Hgrmd at aol.com wrote:
> > >
> > > > Erdinc,
> > > >   Your patient's plight supports my current policy
> > > > of doing tricuspid
> > > > valvuloplasty on around 70% of my mitral procedures.
> > > >  I totally agree with  Bob that
> > > > any documentation of moderate or worse TR on a preop
> > > > echo is a solid
> > > > indication for annuloplasty.  In addition, if the
> > > > systolic annular diameter  exceeds
> > > > 40 mm on the pre-CPB TEE, regardless of the degree
> > > > of TR, the patient  gets a
> > > > ring.  I always use the C-E MC3 ring.  It conforms
> > > > to the  natural 3D geometry
> > > > of the tricuspid annulus.  Better, more flexible,
> > > > rings  will be coming out
> > > > soon.
> > > >
> > > > Hal
> > > >
> > > >
> > > >
> > > > **************The year's hottest artists on the red
> > > > carpet at the Grammy
> > > > Awards. Go to AOL Music.
> > > >
> > > (http://music.aol.com/grammys?NCID=aolcmp00300000002565)
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> --
> Prasanna Simha M
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