[HSF] tricuspid noncoaptation

[Nasser F. Abou'Seada]

"our suggestion to approach the tricuspid, beating heart, via the right
chest is exactly what I would do".
Dear Hal ... why a right thoracotomy ??
difficulty of a redo ??
why a new scar ? and muscle CUTTING procedure ?? especially in a FRIABLE
patient ??

It is always on a beating heart ....

NFA




On Feb 13, 2008 3:06 PM, <hgrmd at aol.com> wrote:

> Dave,
> ? I wouldn't risk a DeVega on any tricuspid repair, because I've seen
> trivial TR become torrential in a very short time frame.? If the annulus is
> dilated, it deserves a ring.
> ? Your suggestion to approach the tricuspid, beating heart, via the right
> chest is exactly what I would do.
>
> Hal
>
>
> -----Original Message-----
> From: David Harris <drdharris at yahoo.co.uk>
> To: OpenHeart-L at lists.hsforum.com
> Sent: Wed, 13 Feb 2008 2:58 pm
> Subject: Re: [HSF] tricuspid noncoaptation
>
>
>
>  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
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>
> Dr. David G. Harris, FCS, MMED,
> Cardiothoracic Surgeon
> Suite 207
> Kuils River Private Hospital,
> PO Box 1200, Kuils River, 7579, Cape Town, South Africa.
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