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  • Reply to Dr. Seggewiss and Rigopoulos

    [Reply to Dr. Seggewiss and Rigopoulos]

    Author: Bob Pensack,MD (---.tnt2.steamboat-springs.co.da.uu.net)

    Date: 10-20-02 13:00

    Dear Dr. Hubert Seggewiss and Dr. Angelos Rigopoulos,

    Thank you for the informative information on septal ablation. I am sorry for any mis information I wrote concerning not giving proper creit to Prof. Ulrich Sigwart for being the original pioneer in performing the first septal alcohol ablation.I recently attended Dr. Barry Maron's and Dr. William Mc Kenna's Summitt on HCM. Your name was on the curriculum for giving the lecture on septal ablation. Perhaps the lecture was given by Prof. Sigwart in your place. I don't know, but once again sorry for the confusion. I had also evidently been given misinformation regarding Dr. Spencer's training having been done under you. I again apologize for the misinformation.

    I thank you for the important info on using contrast echo medium in the target septal branch under echo to assess clearly the area of the septum that you are going to ablate.

    Also, could you please e-mail or post the names of the most expierienced American cardiologists that are using the contrast echo medium technique and those that you would recommend most highly for performing septal ablations on HCM patients.

    I would also like to ask you your opinion about my 28 yo nephew, Bemjamin Pensack's appropriateness for possible septal ablation. I will e-mail you privately with the pertinent information.

    Once again, I thank you for your helpful input.

    Sincerely,

    Bob Pensack,MD

    POB 880610

    Steamboat Springs,CO. 80488

    H-970-879-9057

    Fax-970-879-7457

    e-mail: [email protected]

    ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

    [Re: Reply to Dr. Seggewiss and Rigopoulos]

    Author: H. Seggewiss, A. Rigopoulos (---.dip.t-dialin.net)

    Date: 10-20-02 15:12

    Dear Dr. Pensack:

    Thanks for your reply. Unfortunately, you must have missed me. I gave the talk on that mentioned meeting in Minneapolis. Concerning your nephew you should mail privately. For what I know. the Cleveland Clinic (Harry Lever and colleagues) is using the contrast echo like we do - with the exception that the don`t have Levovist available which turned out to give the best contrast.

    Sincerely

    Hubert Seggewiss

    Leopoldina-Krankenhaus

    Gustav-Adolf-Str. 8

    97422 Schweinfurt

    Phone: +4997217202487

    Fax: +499721 7202984

    Mail: [email protected]

    ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

    [Re: Reply to Dr. Seggewiss and Rigopoulos]

    Author: Lisa Salberg (---.dyn.optonline.net)

    Date: 10-21-02 08:52

    Yes, Lever/Cleveland is using the contrast medium to the best of my knowledge.

    Bob - History is very important in the HCM world, and careful study of the lit. is required to get all the details 100% - I know your thoughts and intentions were well placed and the base data was rather accurate. If you have any questions in the future feel free to send me a private email to confirm any details should you want to confirm anything - the wonderful thing about the web is that if an error is made, no matter how little, thousands of eyes are there to let you know

    Dr. Seggewiss - Nice to see you hear on the message board and thank you for you important work on behalf of all of us with HCM!

    As a strange side note Levovist is produced by a drug company that my brother-in-law works for and he did a large amount of work on the campain to launch the product. I then spoke to the product mgr. in the USA and was told of what a wonderful addition it has been to ablations in HCM, and it was too bad the USA did not yet have it available. Yet 1 more way my life takes an odd twist!

    Best to all,

    Lisa

    ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

    [Re: Reply to Dr. Seggewiss and Rigopoulos]

    Author: Erica (---.biz.dsl.gtei.net)

    Date: 10-23-02 10:59

    So ... Levovist is being used in the United States?

    ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

    [Re: Reply to Dr. Seggewiss and Rigopoulos]

    Author: Erica Stolzenberg (---.atlnga1.dsl-verizon.net)

    Date: 10-23-02 18:50

    What do the following abbreviations mean?

    RVDD

    IVSD (aortic root left areal size)

    LVPWD

    LVDD

    LVDS

    ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

    [Re: Reply to Dr. Seggewiss and Rigopoulos]

    Author: Sarah B.-Board Moderator (---.client.attbi.com)

    Date: 10-23-02 23:02

    Dear Erica,

    Levovist is NOT used in the US, but another contrast medium is.

    LV means left ventricle and RV is right ventricle. Without knowing the context, I can't tell you what DD or DS means. Your doctor's office should be able to tell you--try the nurse, they are easier to get ahold of.

    take care,

    Sarah

    ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

    [Re: Reply to Dr. Seggewiss and Rigopoulos]

    Author: Erica Stolzenberg (---.atlnga1.dsl-verizon.net)

    Date: 10-23-02 23:08

    Sara ... these are abbreviations from either my father's echo or cardiac cath report. There are measurements besides these letters but not knowing what these terms mean doesn't help! We were trying to figure out what his septum size was according to the report! Thanks!

    ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

    [Re: Reply to Dr. Seggewiss and Rigopoulos]

    Author: Sarah B.-Board Moderator (---.client.attbi.com)

    Date: 10-24-02 01:33

    Dear Erica,

    I pulled out some of my echos.

    here are what the Normal Values are (according to Northwestern Memorial Hosptial):

    RV size end diastolic superior (RVDS) 0.7-2.3cm

    LV size end diastolic superior (LVDS) 3.5-5.1cm

    LV size end systolic superior 2.3-3.4cm

    LVPWD left ventricle posterior wall diastolic 0.65-1.1cm

    IVSD (intra-ventricluar septal wall thickness diastole) 0.5-1.0cm THIS IS THE IMPORTANT ONE.

    Aortic root 2.0-3.7cm

    LAD -left atrium diameter 1.9-4.0cm

    from the AHA:

    The heart contracts and relaxes with each heartbeat. The contraction part of this cycle is called systole (SIS'to-le). The relaxation portion is called diastole (di-AS'to-le). In some people with heart failure, the contraction function is normal but there's impaired relaxation of the heart. This affects the heart's lower, pumping chambers (the ventricles) specifically. If the relaxation part of the cycle is abnormal, it's called diastolic (di"as-TOL'ik) dysfunction. Because the ventricle doesn't relax normally, the pressure in it increases and exceeds what's normal as blood for the next heartbeat enters. (It's harder for all of the blood to go into the ventricle.) This can cause increased pressure and fluid in the blood vessels of the lungs. (This is called pulmonary congestion.) It can also cause increased pressure and fluid in the blood vessels coming back to the heart. (This is called systemic congestion.) People with certain types of cardiomyopathy (kar"de-o-mi-OP'ah-the) may also have diastolic dysfunction.

    Posterior means behind.

    Hope this helps.

    S
    NOTE: This is a post from the previous forum message board.

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