[HSF] Thoracic Pseudoaneurym

[Tea Acuff]

I completely agree with Michelangelo on both accounts.
tea



----- Original Message ----
From: "Michael Vincent Smith, MD" <cardsurg at bellsouth.net>
To: OpenHeart-L at lists.hsforum.com
Sent: Tuesday, May 27, 2008 10:37:57 PM
Subject: RE: [HSF] Thoracic Pseudoaneurym

I will attempt to upload films tomorrow.

Michael Vincent Smith, MD

"The greatest danger for most of us is not that our aim is too high and we
miss our goal, but that it is too low and we reach it" -Michelangelo
-----Original Message-----
From: openheart-l-bounces at lists.hsforum.com
[mailto:openheart-l-bounces at lists.hsforum.com] On Behalf Of zzhoumd at pol.net
Sent: Tuesday, May 27, 2008 10:16 PM
To: OpenHeart-L at lists.hsforum.com
Subject: Re: [HSF] Thoracic Pseudoaneurym


Michael,

Any chance you can post couple of CT film pictures?

Zhandong

Sent via BlackBerry by AT&T

-----Original Message-----
From: tdmartin2000 at aol.com

Date: Tue, 27 May 2008 21:13:26 
To:OpenHeart-L at lists.hsforum.com
Subject: Re: [HSF] Thoracic Pseudoaneurym


Michael
I am a little confused by the statement on erythropoeitin. At a hgb of 12.6
that would put his hct at about 37 or 38- correct? I would use epo until I
could get the Hct in the 45 range. I would then use everything possible to
prevent bleeding intra op, including aprotinin, meticulous technique, and
possibly some type of endovasular occlusion of the origin of the aneurysm if
it is indeed small. If you do all of this I believe your mortality should be
more than acceptable and run in the 20 to 30% range.? We have done some
pretty difficult operations in JHWs over the yrs including 3rd time redo
triple valves, ruptured descending, acute type 1 dissection, and a redo root
for prosthetic endocarditis and hemolysis (Ann Thor Surg, Aug 2004). The pt
has to be a good 70 year old however with few if any comorbidities and a
good ventricle.

Tom Martin
U of Florida
Gainesville


-----Original Message-----
From: Hgrmd at aol.com
To: OpenHeart-L at lists.hsforum.com
Sent: Tue, 27 May 2008 8:11 pm
Subject: Re: [HSF] Thoracic Pseudoaneurym



Michael,
  For a case like that, my response would be "no transfusions?, no
surgery." 
To me the likelihood is small that he would survive without any  blood 
components.  Perhaps Dr. Martin feels differently.

Hal



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