[HSF] Aortic Valve Stenosis and Carotid Stenosis

Wed Jan 23 20:13:01 EST 2008

Therefore it is probably and partially not related to patching and shunting, perhaps largely not depending on how partially.

tea

----- Original Message ----
From: "hgrmd at aol.com" <hgrmd at aol.com>
To: OpenHeart-L at lists.hsforum.com
Sent: Wednesday, January 23, 2008 1:16:33 PM
Subject: Re: [HSF] Aortic Valve Stenosis and Carotid Stenosis

Erdinc,
  Frankly, I don't know what "S" stands for in NASCET.  However, I'm quite sure that the 70% threshold applies, regardless of symptoms.  My understanding is that this holds as long as the operative stroke rate is less than 4%.  I don't know exactly what my career average is regarding perioperative strokes, but I would suspect it is no more than 1%.  The reason probably is partially due to the fact that I shunt and patch virtually every patient.

Hal

-----Original Message-----
From: erdinç naseri <enaseri at hotmail.com.tr>
To: openheart-l at lists.hsforum.com
Sent: Wed, 23 Jan 2008 12:01 pm
Subject: RE: [HSF] Aortic Valve Stenosis and Carotid Stenosis

al,
oesn't S in NASCET stands for symptomatic.
rdinc
To: OpenHeart-L at lists.hsforum.com> Subject: Re: [HSF] Aortic Valve Stenosis 
nd Carotid Stenosis> Date: Wed, 23 Jan 2008 11:24:39 -0500> From: 
grmd at aol.com> CC: > > > Erdinc,> >  I beg to differ with your statement that 
here is unclear benefit in operating severe asymptomatic carotid stenoses.  
hough I'm not an expert in the vascular literature, I do believe the NASCET 
tudy, first published in 1994, did demonstrate a lower incidence of stroke with 
urgery for stenoses greater 70% in patients otherwise expected to live at 
eaast 5 years.  I well remember when this study came out (multicenter trial 
unded by the NIH).  My caseload of carotids skyrocketed.  I have boarded 
ascular surgeons in my group, and I know that our current management of carotid 
isease is based on this study.> > Hal> > > -----Original Message-----> From: 
rdinç naseri <enaseri at hotmail.com.tr>> To: openheart-l at lists.hsforum.com> Sent: 
ed, 23 Jan 2008 10:53 am> Subject: RE: [HSF] Aortic Valve Stenosis and Carotid 
tenosis> > > > > > he value of surgery in asymptomatic carotid stenosis , be it 
ilateral ,and in > his case less than 90% ( which is the stenosis criteria in 
ost of the studies > is not clear.Whatver the decision ,it wouldn't be based on 
vidence and only > ndividualized decision according to the treating surgeon's 
xperiences.> rdinc > From: Hgrmd at aol.com> Date: Tue, 22 Jan 2008 21:48:15 
0500> Subject: > e: [HSF] Aortic Valve Stenosis and Carotid Stenosis> To: 
penHeart-L at lists.hsforum.com> > C: > > Ani, Ed, and Others,> This patient has 
evere, symptomatic a.s. and > evere asymptomatic carotid > disease. I would do 
he aortic valve first. If the > atient otherwise looks > like she will survive 
years, then fixing > symptomatic carotid disease, > greater than 70%, is 
ndicated. I would do the > irst carotid about a month after > the heart 
urgery. The second one would be > one a month later. If the > patient isn't 
oing well after the heart surgery, > orget about the carotids.> > Hal> > > > 
*************Start the year off right. > asy ways to stay in shape. > 
ttp://body.aol.com/fitness/winter-exercise?NCID=aolcmp00300000002489> > 
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