How to manage ?
Unstable patients (Real shock or impending shock . . .please note every one with 90mmhg pressure is not unstable !)
Four approaches available
* Exceptional case not to be taken as a model for management.
There is rarely an agreement between surgeon and cardiologist in timing intervention in VSR patients. Treatment protocols vastly differ in various institutions with the common theme being early surgery .
Cath based therapy for VSR closure is still considered a cardiology adventure sport .
Some observations about VSR