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We have a patient on our list for hyperbaric treatments that has a Liva Nova annuloplasty (mitral) ring inserted in 2020 and a Atriclip LAA exclusion system also inserted in 2020. We plan on diving him to 2.4 ATA. I am waiting to hear from the companies but I am not aware of any contraindications to him diving. I would greatly appreciate your perspective.
Oct 3, 2021 by Tina Steichen-Smith,
1 replies
Eugene Worth
MD, M.Ed., FABA, ABPM/UHM
Tina, my concern is the patient's underlying health problems. I assume that this patient had mitral stenosis and a-fib ... thus the the need for an annuloplasy and an atrial clip/occluder. So, my first thought is to discuss the health problems with the cardiologist and be sure that the patient is stable. As for exercise, I feel good if the patient can climb a flight of stairs without extreme exertion fatigue. I would like to see an echocardiogram, but that's just my opinion. The exam isn't required.

Now, your question is about the hyperbaric stability of the medical devices. You have started the process of getting information from the manufacturers. Great! Don't be too surprised if they have no hyperbaric data. As long as the device has no implanted power (battery) or air-filled chamber, I would work with the safety officer of your clinic to put these devices in the exceptions log and move ahead.

If you have further concerns, you may certainly go to the UHMS website and ask the same question to the UHMS Safety committee via MedFAQs. They would be happy to assist. I sit on this committee and can tell you that we have not addressed these two items recently.

Good luck.
Oct 3, 2021
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