[HSF] Mitral ring redux

[Tea Acuff]

When you put it that way, what else can be said?

tea



----- Original Message ----
From: "hgrmd at aol.com" <hgrmd at aol.com>
To: OpenHeart-L at lists.hsforum.com
Sent: Tuesday, May 6, 2008 1:40:47 PM
Subject: Re: [HSF] Mitral ring redux

Yes, it is primarily a ventricular problem, but so is all the mitral repair we do for MR secondary to a myopathic ventricle.  Those are also the repairs most likely to fail.  The problem is inadequate tissue to cover the orifice.  Why do a half assed job when the more durable method is also quick in experienced hands?

Hal
Sent from my Verizon Wireless BlackBerry

-----Original Message-----
From: Tea Acuff <tacuff at swbell.net>

Date: Tue, 6 May 2008 07:33:45 
To:OpenHeart-L at lists.hsforum.com
Subject: Re: [HSF] Mitral ring redux


We are starting to talk theoretically or as Bob would say nonsense.
What papers show that LV suture annuloplasty COMBINED with SVR leads to excess (more than say with rings) intermediate term recurrent MR? It is primarily a ventricular problem, no?

tea



----- Original Message ----
From: "Hgrmd at aol.com" <Hgrmd at aol.com>
To: OpenHeart-L at lists.hsforum.com
Sent: Tuesday, May 6, 2008 6:22:36 AM
Subject: Re: [HSF] Mitral ring redux

Tea.
  Sorry if I insulted you, but my limited experience with about 20  SVR's is 
that nearly everyone of them had at least moderate MR and required  
annuloplasty (ETlogix).  To me, it's no wonder since the whole ventricle  usually has 
some element of dilatation.
  Anyway, if Menicante has good postop echo data (high percentage of  
followup) on his DeVega annuloplasties, please show me the paper and I'll be  happy 
to eat my words.  Like I said, he didn't sound too convincing when I  directly 
questioned him at ISMICS.  As I recall, he said something to the  effect that 
long term follow up wasn't very complete, but that the ones he had  echoed had 
good results.  
  If you think about it, why should ventricular side DeVegas for SVR  do well 
when they haven't for regular cases as demonstrated in several recent  
reputable studies?

Hal



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