Dipartimento di CardioToracoVascolare

UOC Cardiochirurgia – Direttore FF: Dr. Guido Gelpi

Tel. 02 550334084
mail:cardiochirurgia@policlinico.mi.it

Milano 19,12,2022

Dear Colleague,

Today I visited Mr. MADBAR Mamun born on 07.05.97 which came to my attention due to the
finding of heart murmur and diagnosis of severe Mitral regirgitation from P2 flail associated
with left atrial dilatation and initial left ventricular dilatation (LVEDD 56mm).

Physical Examination

• Rhythmic cardiac activity, Early midsystolic murmur 3/6 on M focus irradiated to

axilla

• Abscence of bilateral carotid murmur

• Vesicular Murmur present on the whole Thoracic area

Instrumental Exams

TTE: severe prolapse MI / P2 Flail with left atrial (Ap 46mm) and left ventricular dilatation.

DIAGNOSTIC CONCLUSIONS

Surgical indication for mitral valve repair / replacement by a minimally invasive technique
approach (Periareolar Right Thoracotomy) depending on the outcome of the coronary
angiograph) which the patient seems to accept with some logistical problems.

As a time horizon I would suggest not to exceed 6 months

Alternative plan is to carry out the procedure in India (due to geographical proximity with
the family),

the patient accepts in any case the waiting list inclusion with the following data:
Madbar mamum born in Daha Bangladesh 05.7.97 via cesare alici 17 tel 3314307528

THERAPEUTIC ADDRESS

It is advisable to start oral furosemide and ACE inhibitor at low doses until the procedure.

It is advisable to carry out the next annual check-up in the cardiology field and refer the
patient to our clinic if clinical problems of surgical interest should arise:

Present yourself at your next check-up with this letter.

For subsequent check-ups, contact the toll-free number no. 800638638.

Available for further clarification

Dott Andrea MANGINI