[HSF] tricuspid noncoaptation

[erdinç naseri]

Hal,
1.You are right. never compared it to any other assessment method.
2.I doubt the validity of  TEE data wrt tricuspid valve.
erdinc
> To: OpenHeart-L at lists.hsforum.com> Subject: Re: [HSF] tricuspid noncoaptation> Date: Fri, 15 Feb 2008 21:03:01 -0500> From: hgrmd at aol.com> CC: > > > Nasser, Prasanna, Erdinc,> >   I've been reading this never ending thread with a little skepticism regarding the validity of finger palpation in assessing TR.  How do you know this technique is any good?  Certainly, that was the way I was taught over 20 years ago, but we didn't have routine TEE.  Have any of you done this finger palpation, made an assessment, and then compared it to TEE?  I would bet not.> > > > Hal> > > -----Original Message-----> From: Nasser F. Abou'Seada <nfaabouseada at gmail.com>> To: OpenHeart-L at lists.hsforum.com> Sent: Fri, 15 Feb 2008 2:29 pm> Subject: Re: [HSF] tricuspid noncoaptation> > > > > Dear erdinc> - I have no doubt of your judgement. I share with you the dilemma of not> eing re-imbursed for whatever you do in an operation ......... believe me> .. even with international insurrance companies ......... I had the> xperience of a big European insurance company.... respectable name ... not> aying me AFTER the operation ... it is not only in a certain part of the> orld .... it is everywhere ........ the issue is .... we can not just stop> here unable to do something ....... hence my advocation for a no cost> echnique ..... like a DeVega annuloplasty ........ especially in a> heumatic fibrosed annulus ...... so in a case like yours .. -I have> xperienced many- I would have trusted my finger after all - sure I did> ithout TEE many times- and would have performed a suture annuloplasty based> n the SENSITIVE and SPECIFIC impressions of my finger .......... we> urgeons have our minds at the tip of our fingers ... isn't it ??? -> ifference between a good anastomist and another lies in where the> upination comes from .. the wrist?.. or the MCP joints?- .. right ? .. ..> orry for the extension ...> 2 - that is another reason that I would have advocated doing an SSI approach> .. especially that you are aware of the technique and its implications and> dvantages .... no much difference in time .... in fact might be less ....> ut better exposure ...> 3 - I totally agree with you .... consensus is always changing .... I asked> arc de Laval once about what he thinks of the TCPC .... he answered ...that> E did not know ... !!!! .......... "now" he said ... consensus is that it> s a good operation .... in a few years time ... who knows .... might be> etter improved .. superceeded by another technique .... might be otherwise> ... consensus is always changing ... no dogma whatsoever .... no technique> or concept is revelated no divine role .... it is what we infere from> xperience .... whether scientifically controlled with Stat ... or just> nferences ...> 4- as for DeVega .... I quiet agree ......... yet, IMHO .... we can not be> ogmatic .. whether with or against ..... certainly to condemn DeVega> echnique ... is a total arrogance ...... and to presume it is the best> echnique .... is even worse ... ignorance .... as we were taught in> lementary ABC in ENGLAND .... "it is ACCORDING TO ...... according to the> ype of patient, pathological process affecting the ventricle and valve ....> vailable logistics -rings e.g.- .... consensus of opinion .... and above> ll ... state of funding and re-imbursement .....> certainly it is a marvelous technique that has saved a lot .... and still> as got a place in our surgical armamentarium .... at least for me .....> according to the situation- ...!!!> thank you for your communication> Yours> NFA> > > On Fri, Feb 15, 2008 at 12:11 PM, erdinç naseri <enaseri at hotmail.com.tr>> rote:> >> Dear Nasser,> 1. My fingertip data showed trivial Tr at 1.st operation> 2.For me there is a difference of 10 minutes between closing a L atriotomy> in single row and closing LA roof and interatrial septum in 2 rows before> declamping.> 3.There is not always a concensus in every situation between the 2> circles.e.g long chain of postings in this forum about the treatment of> CAD by stents and surgery.> 4. There are many studies which show no long term benefit of DeVega (> and many studies on the contrary)> 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> -----------------------------------------> > ______________________________________________> penHeart-L mailing list> Send postings to:> OpenHeart-L at lists.hsforum.com> To UNSUBSCRIBE, to CHANGE email address, or to view archives:> ttp://mmp.cjp.com/mailman/listinfo/openheart-l> All messages transmitted by the OpenHeart-L are subject to the policies and > isclaimers posted at:> ttp://www.hsforum.com/listdisclaim> ----------------------------------------> > > ________________________________________________________________________> More new features than ever. Check out the new AOL Mail ! - http://webmail.aol.com> _______________________________________________> 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> -----------------------------------------