[HSF] decalcifying the aortic annulus: opinions

V. Aldrete, M.D. valdretemd at shaw.ca
Mon Jan 5 14:37:27 EST 2009 

I googled CUSA and got over 2 million hits.  Here are the most  
prominent, now that we know what was being talked about.

Calgary United Soccer Association (CUSA)
Carleton University Students’ Association’s (CUSA)
Credit Union Software and Services -  CUSA
CUSA - Chinese Undergraduate Student Association at UW - Madison
Colchester United Supporters Association.

Acronyms are indeed a problem for communication.


On Jan 5, 2009, at 1:54 PM, JBechler at samhealth.org wrote:

> CUSA
>
> Cavitron Ultrasonic Surgical Aspirator
>
> More information available here:  http://www.radionics.com/products/cusa/excel.shtml
>
> Jan
>
> -----Original Message-----
> From: openheart-l-bounces at lists.hsforum.com [mailto:openheart-l-bounces at lists.hsforum.com 
> ] On Behalf Of Tea Acuff
> Sent: Monday, January 05, 2009 1:39 PM
> To: OpenHeart-L at lists.hsforum.com
> Subject: Re: [HSF] decalcifying the aortic annulus: opinions
>
> I don't what it stands for. It is like a blunt harmonic scapel that  
> was used initially for liver (and brain?) resection.  It vibrates  
> out the parenchemal cells but leaves the collagen to secure closure  
> of the residual resection. It also melts the calcium and leaves the  
> annulus on mitral surgery.
> Tea
> Sent from my iPhone
>
> On Jan 5, 2009, at 1:08 PM, Roberto Battellini <robertobattellini at hotmail.com 
> > wrote:
>
>
> Again, you, friends of Verkürzungen, (abbreviations) (Vita brevis)  
> we do not understand them
> CUSA is a Verkürzung, Bob said we should promote comprehension....
>
> What is a CUSA? an ultrashall decalzificator????
>
> Roberto> Date: Mon, 5 Jan 2009 10:16:41 -0800> From:  
> tacuff at swbell.net> Subject: Re: [HSF] decalcifying the aortic  
> annulus: opinions> To: OpenHeart-L at lists.hsforum.com> CC: > > I  
> agree. However, at least until I am reeducated I find it unnecessary  
> in the aortic position but more useful in the mitral where  
> calification so redundant.> > tea> > > > >  
> ________________________________> From: "Goldman, Scott" <GoldmanS at MLHS.ORG 
> >> To: OpenHeart-L at lists.hsforum.com; OpenHeart-L at lists.hsforum.com>  
> Sent: Monday, January 5, 2009 10:59:00 AM> Subject: Re: [HSF]  
> decalcifying the aortic annulus: opinions> > Try using a CUSA. Takes  
> only the calcium and leaves all normal tissue behind.> > Scott > >  
> -----Original Message-----> > From:  "Tea Acuff"  
> <tacuff at swbell.net>> Subj:  Re: [HSF] decalcifying the aortic  
> annulus:  opinions> Date:  Mon Jan 5, 2009 9:00 am> Size:  4K> To:  "OpenHeart-L at lists.hsforum.com 
> " <OpenHeart-L at lists.hsforum.com>> > The Goldilocks Effect. Is that
> literature a German report, Roberto? > Tea > > Sent from my iPhone >  
> > On Jan 4, 2009, at 11:16 AM, Roberto Battellini <robertobattellini at hotmail.com 
> > wrote: > > > Tea, > We agree in Germany that the annulus should be  
> completely decalcified but without going into the annulus.May be  
> Cooley saw some disasters? > Too much is an error, too less  
> also.Exactly is better.We operate the valves with loupes. > > May be  
> bob should write THAT "lecture" > Roberto> Date: Sun, 4 Jan 2009  
> 07:03:52 -0800> From: tacuff at swbell.net> Subject: Re: [HSF] Request  
> for SJM data from Prasanna> To: OpenHeart-L at lists.hsforum.com> CC: >  
> > Could you elaborate on failure to decalcify especially since  
> Cooley is quoted as saying too much is the worst error?> Obviously  
> your point that in vivo " sizes" are different and one would  
> "assume" the gradient is the market for the heart, but should not  
> the surgeon not fit what will easily go or enlarge to fit what will  
> easily go instead of rt21 vs
> pq23 vs xz22?> Tea> > Sent from my iPhone> > On Jan 4, 2009, at 7:01  
> AM, Rwmfglycar at aol.com wrote:> > > In a message dated 1/3/2009  
> 11:11:40 A.M. Eastern Standard Time, > tacuff at swbell.net writes:> >  
> Yes. It was kind of a fun puzzle. But what does the data mean vis a  
> vis the > implanting surgeon? That is, is this not a statement of  
> the obvious: some > valves have bigger holes but the biggest  
> variable ("no thing") is the surgeon?> Tea > > > > > You are  
> absolutely right, the size of the hole of a mechanical valve is the  
> > most important determinant of forward flow performance. Remember  
> first the > importance of the relationship between mounting size and  
> internal orifice, and > then that the size of the hole is not  
> determined just by the internal > diameter of the housing. The shape  
> of the orifice can make a difference and the > occluder must be  
> factored in. Different occluders produce different effects on >  
> transvalvular flow, with varying degrees of
> turbulence. Then there is the > obligatory closing volume (i.e. the  
> flow back through the orifice that is > necessary to close it; done  
> so much better by nature) and the leakage during closure > which can  
> be zero or a definitely measurable amount. Engineers like to put >  
> all this together, into what they call Energy Loss. In vitro  
> performance can > be very precisely measured. and differences  
> between two designs clearly shown. > Clinically the > noninvasive  
> measurements are far less precise. You have > suggested that  
> surgeons have an effect on valve performance.> The great majority of  
> surgeons handle aortic valve replacement very > well but you are  
> right; the surgeon can interfere with the hemodynamic result in > a  
> number of ways which if I were to describe them would be a lecture.  
> In the > aortic position the single most common error in performance  
> is failure to > decalcify the annulus completely. I would add only  
> that this longheld opinion > has been
> confirmed during the last nine years of consulting for a valve >  
> company.> Bob> **************New year...new news. Be the first to  
> know what is making > headlines. (http://www.aol.com/?ncid=emlcntaolcom00000026 
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