[HSF] endocarditis

[Prasanna Simha M]

Hal what VAD do you use ?
Prasanna

On Tue, Mar 11, 2008 at 5:50 PM,  <hgrmd at aol.com> wrote:
> I would certainly have whatever left assist device you've got ready to use.
>
>
>  Hal
>  Sent from my Verizon Wireless BlackBerry
>
>  -----Original Message-----
>  From: "gustavo abuin" <gabuin at intramed.net>
>
>
> Date: Sun, 9 Mar 2008 23:32:27
>  To:<OpenHeart-L at lists.hsforum.com>
>
>
> Subject: Re: [HSF] endocarditis
>
>
>  Hal. Do you suggest to use directly the centrifugal pump instead to try a
>  difficult-impossible weaning for the pump?
>  It´s an option. I will try a weaning with inotropes milrinone-noradrenaline
>  ONCE. If the patient says "what are you talking about gustavo" then I will
>  place a left assistance.
>  Continue  reading suggestions, Thanks.
>  gustavo.
>  ----- Original Message -----
>  From: <hgrmd at aol.com>
>  To: <OpenHeart-L at lists.hsforum.com>
>  Sent: Sunday, March 09, 2008 7:29 PM
>  Subject: Re: [HSF] endocarditis
>
>
>  > Gustavo,
>  >  With an EF that bad and presumably normal coronaries, I doubt your
>  > patient would survive the clamp time I would need to correct all the
>  > problems you describe.
>  >
>  > Hal
>  > Sent from my Verizon Wireless BlackBerry
>  >
>  > -----Original Message-----
>  > From: "gustavo abuin" <gabuin at intramed.net>
>  >
>  > Date: Sun, 9 Mar 2008 10:38:11
>  > To:<OpenHeart-L at lists.hsforum.com>
>  > Subject: [HSF] endocarditis
>  >
>  >
>  > 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