[HSF] 4th rime reop mitral valve

[tdmartin2000 at aol.com]

with only mild AI and a homograft only 4 yrs old I would think it could stay the same for 10 plus yrs.

Tom Martin


-----Original Message-----
From: Michael Firstenberg <msfirst at gmail.com>
To: OpenHeart-L at lists.hsforum.com
Sent: Sat, 24 May 2008 9:18 pm
Subject: Re: [HSF] 4th rime reop mitral valve


what are you going to do when he needs his homograft redone in a couple of years??
anyone vote to take that out and put in a mechanical valved conduit??
(granted it is not that much of a problem now.....)?
?
-michael?
?
On May 24, 2008, at 9:11 PM, tdmartin2000 at aol.com wrote:?
?
> Only you and the pt can decide whether or not to reoperate, but if > you do I think I would opt for either a right or left thoracotomy.?
>?
> Tom Martin?
> U of Florida?
> Gainesville?
>?
>?
> -----Original Message-----?
> From: Douville, Chuck <ecdouville at orclinic.com>?
> To: OpenHeart-L <OpenHeart-L at hsforum.com>?
> Sent: Sat, 24 May 2008 2:20 pm?
> Subject: [HSF] 4th rime reop mitral valve?
>?
>?
>?
> Consult for the members from yesterday. 50 yr old male, former IV > drug abuser?
> with hepatitis C but none for 4 years, current alcohol user and > smoker. History?
> dates back to 2004 when he had a homograft root AVR for > endocarditis; returned?
> to OR for bleeding and IABP but made it through. In 2005 presents > with severe MR?
> and CHF; undergoes transsternal Mitral repair with quadrangular > resection and?
> physio ring. Six months later (now 2006) undergoes redo transternal > MVR with a?
> St. Jude biocor valve for severe Mitral insufficiency. He now > presents to our?
> institution for the first time with CHF and has a 23 mm mean > gradient across his?
> bioprosthetic mitral valve (effective orifice area 1.03) and CHF. > EF is 50% with?
> mild Aortic insufficiency in the homograft root. He is cirrhotic > with an INR of?
> 1.3, Transaminases are 3X normal and his serum albumin is 2.7 (nl > is 3.5 in our?
> institution).Serum creatinine is normal but his platelet count is > 50K. No?
> ascites on ultrasound, No varices on esophagoscopy. HIs blood > cultures are?
> negative.?
>?
> His three sternotomies in 4 years have not worked out particularly > well. Who?
> wants to operate??
>?
>?
> _______________________________________________?
> 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?
> -----------------------------------------?
?
_______________________________________________?
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 anddisclaimers posted at:?
http://www.hsforum.com/listdisclaim?
-----------------------------------------?