FW: New [HSF] Case

[Prasanna Simha M]

It was an article in Circulation. I will have to dig it out.
Prasanna

On Sat, Oct 4, 2008 at 1:41 AM, Tea Acuff <tacuff at swbell.net> wrote:

> Reference?
> tea
>
>
>
> ----- Original Message ----
> From: Prasanna Simha M <prasannasimha at gmail.com>
> To: OpenHeart-L at lists.hsforum.com
> Sent: Friday, October 3, 2008 1:41:40 PM
> Subject: Re: FW: New [HSF] Case
>
> Incidentally in hypertensive aortic dilatation beta blockade monotherapywas
> found to be superior to Losartan monotherapy though both decreased
> progression of dilatation.
> Prasanna
>
> On Sat, Oct 4, 2008 at 12:05 AM, Prasanna Simha M
> <prasannasimha at gmail.com>wrote:
>
> > I am not sure about Non Marfans patients.I have shifted to Losartan in
> them
> > too though I am not sure there is evidence there (for eg Bicuspid valves
> -
> > some evidence of benefit there too). Beta blockers have been found to be
> > inferior compared to Losartan in "preventing" progression of disease
> while
> > beta blockers eem to "slow " down the disease. There are theories that
> the
> > action is realted to metalloproteinases etc etc which seem to also be
> > invoved in bicuspids etc..
> > Currently I use Losartan with beta blockers.
> > Prasanna
> >
> >
> > On Fri, Oct 3, 2008 at 11:39 PM, Douville, Chuck <
> ecdouville at orclinic.com>wrote:
> >
> >> Prasanna is losartan also believed to alter the natural history of
> aortic
> >> dilatation in non-Marfan's patients. I believe you suggested this
> >> previously, but I want to make sure. Are you using both losartan and
> beta
> >> blockade in your aneurysm patients? thx chuckdouville
> >>
> >> ________________________________
> >>
> >> From: openheart-l-bounces at lists.hsforum.com on behalf of Prasanna Simha
> M
> >> Sent: Fri 10/3/2008 9:28 AM
> >> To: OpenHeart-L at lists.hsforum.com
> >> Subject: Re: New [HSF] Case
> >>
> >>
> >>
> >> This patient has demonstrated "leakability of all the valves. I think it
> >> is
> >> important to fix everything. MV repair + TV repair is required. I would
> >> start Losartan . There is increasing evidence that Losartan can actually
> >> reverse the changes of Marfans and decrease the progression of AI and
> >> aortic
> >> dilatation so much soo that some Marfans centres think it will be the
> >> "magic
> >> bullet" for Marfans. The effect is seen with Losartan and not with ACE
> >> Inhibitors. The exact cause is not known but some changes occur in the
> >> molecular level preventing the dilatation etc.
> >> I have fixed one childs nitral and tricusid and am observing his aortic
> >> now
> >> for 2 years and is stable.
> >> Prasanna
> >>
> >> On Fri, Oct 3, 2008 at 8:50 PM, <ichfno at aol.com> wrote:
> >>
> >> > What to do in 2 y.o., Marfan's with 3+ MR, 3+ TR, 1+ AI and PI?
> >> >
> >> > WNovick
> >> >
> >> > -----Original Message-----
> >> > From: Michael Firstenberg <msfirst at gmail.com>
> >> > Sent: October 03, 2008 5:41 PM
> >> > To: OpenHeart-L at lists.hsforum.com
> >> > Subject: Re: [HSF] Case
> >> >
> >> > my take on these types of patients is that the MR, if the valve and
> >> annulus
> >> > are normal, is a functon of the AS and gets better over time.  Based
> >> upon
> >> > the info provided, I would do an AVR and a PVI - but I am sure others
> >> would
> >> > be much more aggressive.......... also depends on the eye-ball test.
> >> >
> >> >
> >> > -michael
> >> >
> >> > On Fri, Oct 3, 2008 at 10:04 AM, <DukeB60 at aol.com> wrote:
> >> >
> >> > > 75 yo. female, normal LV, severe AS with  80mmHg. peak gradient, AVA
> >> > > 0.6cm2,
> >> > > normal CA's, chronic persistent AF, moderate  MR.  Referred for AVR.
> >> >  Would
> >> > > members of the Forum also do a Maze  and if so what lesion set.
> Would
> >> > > members
> >> > > also perform a mitral  repair.  Annulus not heavily calcified, no
> >> leaflet
> >> > > prolapse, annular  dilation.  LA not dilated.
> >> > >
> >> > >
> >> > >
> >> > >
> >> > >
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> >>
> >> --
> >> Prasanna Simha M
> >> _______________________________________________
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> >
> >
> >
> > --
> > Prasanna Simha M
> >
>
>
>
> --
> Prasanna Simha M
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-- 
Prasanna Simha M