[HSF] endocarditis

[Prasanna Simha M]

I presume that this is an RSOV ???? The windsock can be excised and
patched bicamerally.. The VSD can be closed seperately through the
aortotomy. You can use a ring to achieve a coaptation of at lest 10
mm.
Use Milrinone dobutamine  sos Noradrenaline while coming of CPB in these cases.
Prasanna

On Sun, Mar 9, 2008 at 7:08 PM, gustavo abuin <gabuin at intramed.net> wrote:
> Dear members.
>  We have a 28 year old patient with an aorto right ventricular fistula,
>  subaortic VSD (both small), aortic insufficiency, aortic endocarditis,
>  moderate central mitral insufficiency with no structural disease of the
>  valve and 18% of EF, 88 of end diastolic diameter.
>  no pulmonary hypertension, no RV failure, no organ disfunction.
>  The patient is with antibiotics and low dose of dobutamine, with no fever,
>  no acute signs of cardiac failure.
>  I will place him on the OR next wenesday.
>  I plan to replace the aortic valve, close the defects with a patch or maybe
>  some pledgettes stiches.
>  The question  about the mitral valve in order to treat the mitral annullus
>  and cardiac failure:
>  -pericardium annuloplasty
>  -annuloplasty up to a perfect competence with a proper sized mitral ring.
>  -annuloplasty with a 2-3 downsize mitral ring.
>  -mitral replacement?
>
>  The question about comming offpump:
>  combination of inotropics
>  centrifugal pump directly?
>
>  What do you do in a routine basis in this cases?
>
>  Thanks in advance.
>  gustavo.
>
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-- 
Prasanna Simha M