[HSF] Mitral ring redux

[Prasanna Simha M]

Then MV repair + BV pacer. (For me the second part is not practical due to
costs but I use it at times temporarily perioperatively with success.
Prasanna

On Sat, May 3, 2008 at 7:56 PM, Mitch Lirtzman <drmitch at cox.net> wrote:

> 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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-- 
Prasanna Simha M