[HSF] Image of the week - Tricuspid complete ring implantation

[Nasser F. Abou'Seada]

Excellent Prasanna ...
Congratulations

NFA

On Fri, Feb 15, 2008 at 12:53 AM, Prasanna Simha M <prasannasimha at gmail.com>
wrote:

> Picture showing a complete tricupid inidgenous ring being implanted. Since
> the ring is complete the bites in the region of the conduction system (are
> taken on the base of the septal leaflet rather than the annulus to avoid
> hitting the bundle of His.
> Patient was a 24 year old girl with severe MR and TR with mild TS and
> hepatic dysfunction ( fits into Childs A),giant LA  mild renal failure and
> severe cardiac failure and was on Dobutamine NTG preop. Mitral valve was
> not
> repairable (tried  it but wasn't good) and so was replaced and received a
> emaze and LA reduction.(CTR 85 %) Patient  had a  supra aortic hepatic
> perfusion catheter in place with NTG infusion periop and post op . Bypass
> was done with a pump flow index of 3.4l/m2 and maxed NTG compatible with
> perfusion limits . Hemofiltered on CPB.(2 Bags blood drawn on induction).
> She was weaned of with 3 mics dopa , 3 mics dobut 0.35 mics Milrinone and
> Ad
> lib SNP + Intraaortic NTG.
> Has done well and is of all inotropes @12 hours post surgery. No increase
> in
> hepatic enzymes renal function is good and planning to remove the
> perfusion
> catheter in a few hours time.
> I am not sure if I am overdoing the intraaortic catheter business but the
> patients seem to do extremely well with it compared to historical cohorts
> and my cardiologists also seem to be happy about the outcomes in this sick
> group after I have started using the catheter (They are now sending "given
> up" cases !!)
> --
> Prasanna Simha M
>
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