[HSF] Mitral ring redux

[Mitch Lirtzman]

Being well aware of Bolling's work, I opted not to get into a pissing match 
with my colleague.

Nonetheless, he does have a left bundle, about 0.16- 0.18. By echo and on 
the V-gram, his anterior wall moves, albeit sluggishly.

MitchAt 10:02 PM 5/2/2008, you wrote:
>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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