[HSF] tricuspid noncoaptation

[erdinç naseri]

Hal, 
100% agree with you. Wish someday I had the privilege to work in a near ideal cardiac center .But again will like to go back to less privileged centers to redistribute the wealth of knowledge.
erdinc> To: OpenHeart-L at lists.hsforum.com> Subject: Re: [HSF] tricuspid noncoaptation> Date: Tue, 19 Feb 2008 06:48:23 -0500> From: hgrmd at aol.com> CC: > > > Dear Erdinc,> >   I didn't take it as a slight, and please don't take offense with what I'm about to write.  I just feel badly for you having to routinely operate without TEE.  If your cardiologists are telling you it's not helpful for intraop evaluation of the tricuspid, that is erroneous.  Again, I've visited different cardiac programs with greatly varying degrees of equipment availability.  I'm just fearful that the results for valve surgery can't be as good if the surgeon is basically flying blind.> > > > Hal> > > -----Original Message-----> From: erdinç naseri <enaseri at hotmail.com.tr>> To: openheart-l at lists.hsforum.com> Sent: Tue, 19 Feb 2008 2:56 am> Subject: RE: [HSF] tricuspid noncoaptation> > > > > > al, > o disrespect intended. My Knowledge about echo of any type is provided by > ardiologists ( the ones who are trained for it)> rdinc> To: OpenHeart-L at lists.hsforum.com> Subject: Re: [HSF] tricuspid > oncoaptation> 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 > alve all you want, but the overwhelming evidence supporting its use in > valuating the tricuspid is there if you want to believe it. In addition, I've > ot tons of experience using TEE to evaluate the tricuspid. No question, it has > elped me and my patients.> > Hal> > > -----Original Message-----> From: erdinç > aseri <enaseri at hotmail.com.tr>> To: openheart-l at lists.hsforum.com> Sent: Sun, > 7 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 > alidity of TEE data wrt tricuspid valve.> rdinc> To: OpenHeart-L at lists.hsforum.com> > ubject: 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 > eading this never ending thread with a little > kepticism regarding the > alidity of finger palpation in assessing TR. How do > ou know this technique is > ny good? Certainly, that was the way I was taught > ver 20 years ago, but we > idn't have routine TEE. Have any of you done this > inger palpation, made an > ssessment, and then compared it to TEE? I would bet > ot.> > > > Hal> > > > ----Original Message-----> From: Nasser F. Abou'Seada > nfaabouseada at gmail.com>> > o: 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 > udgement. I share with you the dilemma of not> eing > e-imbursed for whatever > ou do in an operation ......... believe me> .. even > ith international > nsurrance companies ......... I had the> xperience of a big > uropean insurance > ompany.... respectable name ... not> aying me AFTER the > peration ... it is > ot only in a certain part of the> orld .... it is > verywhere ........ the > ssue is .... we can not just stop> here unable to do > omething ....... hence > y advocation for a no cost> echnique ..... like a > eVega annuloplasty ........ > specially in a> heumatic fibrosed annulus ...... > o in a case like yours .. -I > ave> xperienced many- I would have trusted my > inger after all - sure I did> > thout TEE many times- and would have performed a > uture annuloplasty based> n > he SENSITIVE and SPECIFIC impressions of my finger > ......... we> urgeons have > ur minds at the tip of our fingers ... isn't it ??? > > ifference between a > ood anastomist and another lies in where the> upination > omes from .. the > rist?.. or the MCP joints?- .. right ? .. ..> orry for the > xtension ...> 2 - > hat is another reason that I would have advocated doing an > SI approach> .. > specially that you are aware of the technique and its > mplications and> > vantages .... no much difference in time .... in fact might > e less ....> ut > etter exposure ...> 3 - I totally agree with you .... > onsensus is always > hanging .... I asked> arc de Laval once about what he > hinks of the TCPC .... > e answered ...that> E did not know ... !!!! .......... > now" he said ... > onsensus is that it> s a good operation .... in a few years > ime ... who knows > ... might be> etter improved .. superceeded by another > echnique .... might be > therwise> ... consensus is always changing ... no dogma > hatsoever .... no > echnique> or concept is revelated no divine role .... it is > hat we infere > rom> xperience .... whether scientifically controlled with Stat > .. or just> > ferences ...> 4- as for DeVega .... I quiet agree ......... yet, > MHO .... we > an not be> ogmatic .. whether with or against ..... certainly to > ondemn > eVega> echnique ... is a total arrogance ...... and to presume it is > he best> > chnique .... is even worse ... ignorance .... as we were taught in> > ementary > BC in ENGLAND .... "it is ACCORDING TO ...... according to the> ype > f > atient, pathological process affecting the ventricle and valve ....> > ailable > ogistics -rings e.g.- .... consensus of opinion .... and above> ll ... > tate > f funding and re-imbursement .....> certainly it is a marvelous technique > hat > as saved a lot .... and still> as got a place in our surgical > rmamentarium > ... at least for me .....> according to the situation- ...!!!> > hank you for > our communication> Yours> NFA> > > On Fri, Feb 15, 2008 at 12:11 > M, erdinç > aseri <enaseri at hotmail.com.tr>> rote:> >> Dear Nasser,> 1. My > ingertip data > howed trivial Tr at 1.st operation> 2.For me there is a > ifference of 10 > inutes between closing a L atriotomy> in single row and > losing LA roof and > nteratrial septum in 2 rows before> declamping.> 3.There is > ot always a > oncensus in every situation between the 2> circles.e.g long chain > f postings > n this forum about the treatment of> CAD by stents and surgery.> 4. > here are > any studies which show no long term benefit of DeVega (> and many > tudies on > he contrary)> erdinc> > _______________________________________________> > > enHeart-L mailing list> > Send postings to:> OpenHeart-L at lists.hsforum.com> > > > UNSUBSCRIBE, to CHANGE email address, or to view archives:> > > tp://mmp.cjp.com/mailman/listinfo/openheart-l> > All messages transmitted by > > e OpenHeart-L are subject to the policies> and> disclaimers posted at:> > > tp://www.hsforum.com/listdisclaim> -----------------------------------------> > > _____________________________________________> penHeart-L mailing list> Send > > stings to:> OpenHeart-L at lists.hsforum.com> To UNSUBSCRIBE, to CHANGE email > > dress, or to view archives:> ttp://mmp.cjp.com/mailman/listinfo/openheart-l> > > l messages transmitted by the OpenHeart-L are subject to the policies and > > > claimers posted at:> ttp://www.hsforum.com/listdisclaim> ----------------------------------------> > > ________________________________________________________________________> > > re new features than ever. 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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> -----------------------------------------