Цитата:
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Сообщение от alex_md
The area is not critical, but you could have underestimated the gradient in the settings of reduced SV. Also concerning is a mildly decreased systolic function. What is the end systolic diameter of LV? Does he have a significant LVH? What is the mitral filling pattern on tissue Doppler?
Impression:
AV replacemnet is inducated at the time of the surgery with a tissue valve
This 68 y/o male with mild systolic abnormality and moderate to severe AS will need a valve replaced anyway in 2-3 years. My call would be to replace the valve as this would not probably add perioperative mortality but may improve his longterm prognosis. One also need to realize that perioperative mortality in such patients is high to start with, so I would not like to open him twice.
Would be interesting to see what Dr. Habarov has to say.
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Very mild LVH. MVI inflow suggests impaired relaxation. AVR will definately will increase the morbidity. The lesion is not hemodynamically significant. Bioprosthesis will give you the same gradient.