[HSF] tricuspid noncoaptation

[erdinç naseri]

Hal, 
No disrespect intended. My Knowledge about echo of any type is provided by cardiologists ( the ones who are trained for it)
erdinc> To: OpenHeart-L at lists.hsforum.com> Subject: Re: [HSF] tricuspid noncoaptation> Date: Sun, 17 Feb 2008 17:54:49 -0500> From: hgrmd at aol.com> CC: > > Erdinc,>   You can doubt the validity of TEE with respect to the tricuspid valve all you want, but the overwhelming evidence supporting its use in evaluating the tricuspid is there if you want to believe it.  In addition, I've got tons of experience using TEE to evaluate the tricuspid.  No question, it has helped me and my patients.> > Hal> > > -----Original Message-----> From: erdinç naseri <enaseri at hotmail.com.tr>> To: openheart-l at lists.hsforum.com> Sent: Sun, 17 Feb 2008 3:09 pm> Subject: RE: [HSF] tricuspid noncoaptation> > > > > al,> .You are right. never compared it to any other assessment method.> .I doubt the validity of TEE data wrt tricuspid valve.> rdinc> To: OpenHeart-L at lists.hsforum.com> Subject: Re: [HSF] tricuspid noncoaptation> > ate: Fri, 15 Feb 2008 21:03:01 -0500> From: hgrmd at aol.com> CC: > > > Nasser, > rasanna, Erdinc,> > I've been reading this never ending thread with a little > kepticism regarding the validity of finger palpation in assessing TR. How do > ou know this technique is any good? Certainly, that was the way I was taught > ver 20 years ago, but we didn't have routine TEE. Have any of you done this > inger palpation, made an assessment, and then compared it to TEE? I would bet > ot.> > > > Hal> > > -----Original Message-----> From: Nasser F. Abou'Seada > nfaabouseada at gmail.com>> To: OpenHeart-L at lists.hsforum.com> Sent: Fri, 15 Feb > 008 2:29 pm> Subject: Re: [HSF] tricuspid noncoaptation> > > > > Dear erdinc> - > have no doubt of your judgement. I share with you the dilemma of not> eing > e-imbursed for whatever you do in an operation ......... believe me> .. even > ith international insurrance companies ......... I had the> xperience of a big > uropean insurance company.... respectable name ... not> aying me AFTER the > peration ... it is not only in a certain part of the> orld .... it is > verywhere ........ the issue is .... we can not just stop> here unable to do > omething ....... hence my advocation for a no cost> echnique ..... like a > eVega annuloplasty ........ especially in a> heumatic fibrosed annulus ...... > o in a case like yours .. -I have> xperienced many- I would have trusted my > inger after all - sure I did> ithout TEE many times- and would have performed a > uture 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 > omes from .. the wrist?.. or the MCP joints?- .. right ? .. ..> orry for the > xtension ...> 2 - that is another reason that I would have advocated doing an > SI approach> .. especially that you are aware of the technique and its > mplications and> dvantages .... no much difference in time .... in fact might > e less ....> ut better exposure ...> 3 - I totally agree with you .... > onsensus is always changing .... I asked> arc de Laval once about what he > hinks 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 > ime ... who knows .... might be> etter improved .. superceeded by another > echnique .... might be otherwise> ... consensus is always changing ... no dogma > hatsoever .... no technique> or concept is revelated no divine role .... it is > hat we infere from> xperience .... whether scientifically controlled with Stat > .. or just> nferences ...> 4- as for DeVega .... I quiet agree ......... yet, > MHO .... we can not be> ogmatic .. whether with or against ..... certainly to > ondemn DeVega> echnique ... is a total arrogance ...... and to presume it is > he best> echnique .... is even worse ... ignorance .... as we were taught in> > ementary ABC in ENGLAND .... "it is ACCORDING TO ...... according to the> ype > f patient, pathological process affecting the ventricle and valve ....> > ailable logistics -rings e.g.- .... consensus of opinion .... and above> ll ... > tate of funding and re-imbursement .....> certainly it is a marvelous technique > hat has saved a lot .... and still> as got a place in our surgical > rmamentarium .... at least for me .....> according to the situation- ...!!!> > hank you for your communication> Yours> NFA> > > On Fri, Feb 15, 2008 at 12:11 > M, erdinç naseri <enaseri at hotmail.com.tr>> rote:> >> Dear Nasser,> 1. My > ingertip data showed trivial Tr at 1.st operation> 2.For me there is a > ifference of 10 minutes between closing a L atriotomy> in single row and > losing LA roof and interatrial septum in 2 rows before> declamping.> 3.There is > ot always a concensus in every situation between the 2> circles.e.g long chain > f postings in this forum about the treatment of> CAD by stents and surgery.> 4. > here are many studies which show no long term benefit of DeVega (> and many > tudies on the contrary)> erdinc> > _______________________________________________> > penHeart-L mailing list> > Send postings to:> OpenHeart-L at lists.hsforum.com> > > o UNSUBSCRIBE, to CHANGE email address, or to view archives:> > ttp://mmp.cjp.com/mailman/listinfo/openheart-l> > All messages transmitted by > he OpenHeart-L are subject to the policies> and> disclaimers posted at:> > ttp://www.hsforum.com/listdisclaim> -----------------------------------------> > ______________________________________________> penHeart-L mailing list> Send > ostings to:> OpenHeart-L at lists.hsforum.com> To UNSUBSCRIBE, to CHANGE email > ddress, or to view archives:> ttp://mmp.cjp.com/mailman/listinfo/openheart-l> > ll messages transmitted by the OpenHeart-L are subject to the policies and > > sclaimers posted at:> ttp://www.hsforum.com/listdisclaim> ----------------------------------------> > > ________________________________________________________________________> > ore new features than ever. Check out the new AOL Mail ! - http://webmail.aol.com> > ______________________________________________> OpenHeart-L mailing list> > > end postings to:> OpenHeart-L at lists.hsforum.com> > To UNSUBSCRIBE, to CHANGE > mail 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 > > isclaimers 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> -----------------------------------------