[HSF] Mitral ring redux

[Tea Acuff]

More pertinently what is his anterior wall like?

tea



----- Original Message ----
From: Prasanna Simha M <prasannasimha at gmail.com>
To: OpenHeart-L at lists.hsforum.com
Cc: OpenHeart-L at hsforum.com
Sent: Friday, May 2, 2008 10:02:44 PM
Subject: Re: [HSF] Mitral ring redux

There is no thing as a pop of valve MR in current thinking. Stephen Bolling
has proven that well. Wether there will be a sruvival advantage in low EF MR
is a different question altogether.Incidentally has his QRS widened ?
Prasanna
Prasanna

On Sat, May 3, 2008 at 8:18 AM, Mitch Lirtzman <drmitch at cox.net> wrote:

> Please help clarify a point I made concerning mitral repair.
>
> I have a 50yo male smoker with no history of drugs, EtOH, industrial
> exposure, etc, and rather severe CAD. The LAD is previously stented and
> occluded at it's origin. Fills rt-to lt. The Cx has a proximal 90% lesion.
> RCA normal. EF is 20%. LVEDD~ 7cm. TEE shows moderate MR with a central jet
> to mid-atrium. Septum and lateral walls still move. Previously refused by
> another surgeon. They putzed around with him at the local Charity hospital
> til he went into VT...and sent him to me. Still has occasional chest pains
> in ICU.
>
>
> Frankly, the guy has no chance without surgery and at high risk with it.
> I've done bunches of low-EF patients with quite satisfactory results. The
> question is that I plan to put a "quick" ring on his mitral as has been my
> practise for several years. You all know the possible scenario in six months
> with CHF and worsening MR, if the MR is not corrected. The cardiologist
> feels that his LV won't be able to take the added strain without that
> "pop-off valve".
>
> Thanks in advance for your comments and advice in advance.
> Mitch
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-- 
Prasanna Simha M
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