[HSF] Recurrent prosthetic TV endocarditis

[Ani Anyanwu]

With the recurrent pulmonary emboli, what are the PA pressures now? If pulmonary hypertension probably limits options as may not tolerate valvectomy.
 
Also what does the patient want?
 
Ani
 
 



> Date: Sat, 8 Mar 2008 12:49:36 -0800> From: streitman at yahoo.com> To: OpenHeart-L at lists.hsforum.com> CC: > Subject: [HSF] Recurrent prosthetic TV endocarditis> > HS forum:> > I present a case for advice:> > 43 y/o female I operated on 6 months ago with TV> endocarditis (OSSA due to IV drug use). She initially> presented with septic pulmonary emboli and severe TR> with involvement of all three leaflets with 2 separate> 1.5-2 cm vegetations. This required resection and> replacement with a 33mm Perimount valve. She has been> recently readmitted back to her old ways with new> recurrent septic pulmonary emboli and an impressive> vegetation on her prosthetic valve with OSSA in her> blood once more.> > >From an ethical standpoint I question re-operation. > My question for the audience is what options do I have> (resection w/o replacement, re-replacement, etc). Are> there any options for tissue only replacement akin to> a stentless valve for this patient? Thanks for your> input. > > John> > John E Streitman, M.D.> Cardiovascular Surgeon> Firsthealth CVT Surgeons> streitman at yahoo.com> > > ____________________________________________________________________________________> Looking for last minute shopping deals? > Find them fast with Yahoo! Search. http://tools.search.yahoo.com/newsearch/category.php?category=shopping> _______________________________________________> 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> -----------------------------------------
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