AW: [HSF] Rt thoracotomy MVR

Fri Mar 28 01:46:31 EDT 2008

Roberto

Apologies for wrong use of words. What I meant to say was post-cardiotomy shock and not 'stone heart'. sometimes as we write emails so fast we mix up concepts and thoughts and end up mis-expressing ourselves - stone heart is a condition that really has almost ceased existence in the modern era. I suppose though even post-cardiotomy shock is a vague definition as I know at Liepzig you have very low threshold (and also outstanding results) on use of ECMO in this setting.

ANi

> From: battr at medizin.uni-leipzig.de> To: OpenHeart-L at lists.hsforum.com> Subject: AW: [HSF] Rt thoracotomy MVR> Date: Wed, 26 Mar 2008 14:24:23 +0100> CC: > > Ani,> I decided not to answer this comment from you until I had spoken with Fred> and the people doing MICS. Nobody recognizes having had a stone heart by> Mitral MIC. Can you comment the case?> BTW, of course AI is a problem and or a lot of cardioplegia in AI I Grade> must be given or reject the cases with AI II.> I wait for your clear comment.> Roberto Battellini, Leipzig> > > -----Ursprüngliche Nachricht-----> Von: openheart-l-bounces at lists.hsforum.com> [mailto:openheart-l-bounces at lists.hsforum.com] Im Auftrag von Ani Anyanwu> Gesendet: Mittwoch, 12. März 2008 12:40> An: openheart-l at lists.hsforum.com> Betreff: RE: [HSF] Rt thoracotomy MVR> > I do not know - through the side there seems a perception (which i agree> should not hold) that (myocardial) protection may not be optimal so there is> a pressure to complete the surgery on time. I have seen a couple of side> cases come to us for redos where the surgeons either accepted residual MR or> used replacement rapidly to abilout for SAM whereas both would have been> easily solvable if they persisted. I know too of a case done in leipzig> recently through the side that ended with stone heart because of AI ad poor> antegrade protection.> > Ani> > > > > > > Date: Wed, 12 Mar 2008 07:22:40 +0530> From: prasannasimha at gmail.com> To:> OpenHeart-L at lists.hsforum.com> Subject: Re: [HSF] Rt thoracotomy MVR> CC: >> > Why is there a higher threshold for longer Ischemic times with a> median> sternotomy versus thoractomy ?> Prasanna> > On Wed, Mar 12, 2008 at 4:17 AM,> Ani Anyanwu <anianyanwu at hotmail.com> wrote:> > > Why would a sternotomy> improve her chances of a repair?>> > Because of better exposure, better> instrumentation, better comfort and higher threshold to tolerate long> ischemia times. I agree that all these are relative and experienced> 'side-surgeons' can accomplish easily most of what can be done via> sternotomy but that will certainly not be the case with Nand as her rarely> employs such an approach.> >> > Also the reality is very different from the> practice even if you look at expert series and side surgeons definitely> replace the more difficult valves. For example, a critical study of the> series from Mohr, Vanerman and Chitwood - all well versed in side surgery -> would show a higher replacement rate (all more than 10%) that one would> expect for such experienced valve surgeons.> >> > Ani> >> >> >> >> >> > >> To: OpenHeart-L at lists.hsforum.com> Subject: Re: [HSF] Rt thoracotomy MVR>> Date: Tue, 11 Mar 2008 16:26:47 -0400> From: dukeb60 at aol.com> CC: > > Why> would a sternotomy improve her chances of a repair?> > > -----Original> Message-----> From: Ani Anyanwu <anianyanwu at hotmail.com>> To:> openheart-l at lists.hsforum.com> Sent: Tue, 11 Mar 2008 1:09 pm> Subject: RE:> [HSF] Rt thoracotomy MVR> > > > > I have a young lady who underwent pectus> repair many years ago. She now> needs > mitral replacement for severe MR. I> am planning to do it through a> right > thoracotomy.> > Nand> > Why exactly> do you want to do this through a right thoracotomy? Certainly there > is no> indication for a thoracotomy per se as the procedure will be easily >> accomplished via sternotomy. If thoracotomy is not your usual approach for >> mitral surgery, and if it is not the patient requesting a thoracotomy, then> may > be best to stick to the approach you are used to in such an unusual> case.> > Does the patient certainly need a replacement (and why?) - would a> sternotomy > improve her chances of repair or is valve certainly> irreparable?> > ANi> > > > > > Date: Mon, 10 Mar 2008 20:47:10 +1300> From:> nkkejriwal at gmail.com> To: > OpenHeart-L at lists.hsforum.com> Subject: Re:> [HSF] Rt thoracotomy MVR> CC: > > > Hi> > I have a young lady who underwent> pectus repair many years ago. She now> > needs mitral replacement for severe> MR. I am planning to do it through a> right > thoracotomy. I have not done> many of these. The last I did was a> gentleman with > mitral prosthesis> endocarditis last year. In that case, I did> not release too > many> adhesions and did it under fibrillatory arrest.> > In this lady I am hoping> > to cross clamp the aorta. I know some of you have a> large experience with> MVR > through Rt thoracotomy. Any tips?> > Nand>> _______________________________________________> > 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>> ----------------------------------------->> _________________________________________________________________> Telly> addicts unite!>> http://www.searchgamesbox.com/tvtown.shtml__________________________________> _____________> 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>> -----------------------------------------> >> _______________________________________________> 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>> -----------------------------------------> >> >> _________________________________________________________________> > Get> Hotmail on your mobile, text MSN to 63463!> >> http://mobile.uk.msn.com/pc/mail.aspx_______________________________________> ________> >> >> > 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> >> -----------------------------------------> >> > > > -- > Prasanna Simha M>> _______________________________________________> 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>> -----------------------------------------> _________________________________________________________________> Telly addicts unite!> http://www.searchgamesbox.com/tvtown.shtml__________________________________> _____________> 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> -----------------------------------------> > _______________________________________________> 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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