[HSF] endocarditis

[gustavo abuin]

Agree. Thanks
----- Original Message ----- 
From: "Prasanna Simha M" <prasannasimha at gmail.com>
To: <OpenHeart-L at lists.hsforum.com>
Sent: Sunday, March 09, 2008 9:47 AM
Subject: Re: [HSF] endocarditis


>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
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