[HSF] Aortic cusp repair in root reimplantation for AAE

[Tea Acuff]

  I just finished my first case of the day a CABG on a ninety yo who  
plays golf twice a week. He presented with chest pain and wide complex  
tachycardia.

I was relating a few of the intraoperative issues to the family and I  
noticed confusion on the face of the patient's friend, and quickly  
closed with, "Everything looks good now." She immediately smiled, and  
I commented that I could have omitted the intraoperative debriefing.

When I go home tonight surely my wife will understand me!???!


Tea

Sent from my iPhone

On Aug 5, 2009, at 10:09 AM, Prasanna Simha M  
<prasannasimha at gmail.com> wrote:

> Honestly Tea I did not understand a thing so I don't know how to  
> reply.
> Prasanna
>
> On Wed, Aug 5, 2009 at 6:29 PM, Tea Acuff <tacuff at swbell.net> wrote:
>
>>
>> Prasanna,
>> I have been thinking about populations, distributions, and the  
>> philosophic
>> views that we carry individually to give context to these contextual
>> categories. When I see past all the verbiage that we employ, to  
>> that which
>> you actually do, I am amazed how we can be compared. If we were to  
>> compare
>> CVs or compellations of our work, we would see some variations or
>> distribution of the same "family", heart surgeons. However, I see
>> "mispoche", a mish mash of relics somewhat arbitrarily categorized  
>> under a
>> single quintiessential characteristic. Family and mispoche may mean  
>> the
>> same, but their implications and effects are in different worlds.
>> Wow!
>> Tea
>> Sent from my iPhone
>>
>> On Aug 5, 2009, at 6:29 AM, Prasanna Simha M  
>> <prasannasimha at gmail.com>
>> wrote:
>>
>> One of the papers that I presented in Iran  was congenital AR, From  
>> Sept
>> 1997 I have repaired 128 valves with congenital AR and had to  
>> replace and
>> additional 6 which I could not repair. You ned to take a functional
>> approach
>> using 3 levels - ventriculoaortic ,ST jucntion and sinus to factor  
>> in the
>> repair. One important thing is that just because you repaired one  
>> leaflet
>> you cannot asume the other leaflet doesnt require correction  
>> because when
>> you do the VS and ST junction corrections very often the other  
>> leaflet (so
>> called "Norma" will prolapse and that needs correction too.one  
>> problem in
>> children that you have to factor in also is growth potential when  
>> doing
>> such
>> repairs.
>> In the panel on the right yoiu see an obvioulsy badly distorted  
>> cusp in a
>> child with severe AR. You can see the final repair that has been  
>> done and
>> which needed a pretty lot of work. The lower one is another case  
>> which also
>> required multiple maneuvers and corrections to achieve a good result.
>> One small tip - the regurgitant jet always is directed away from the
>> prolapsing cusp
>> Prasanna
>>
>> On Wed, Aug 5, 2009 at 10:56 AM, Tohru Asai
>> <toruasai at belle.shiga-med.ac.jp>wrote:
>>
>> Thanks Prassana
>> I directly went to PubMed to read articles by Gebrain El Khoury.
>> These are something!
>> Tohru
>> Tohru Asai
>> Otsu, Japan
>>
>>
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>>
>> --
>> Prasanna Simha M
>> <CONGENITAL AR RAZAVI.jpg>
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>
>
>
> -- 
> Prasanna Simha M
> _______________________________________________
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