First of all, I'm not a newbie to the forum as I haven't posted in a while (especially after the start of charging for the chat), if you noticed, I joined in april 2007. Secondly, I never referenced the surgery she had when i stated she had lost her atrial kick from the afib, which would cause a lower ejection fraction by itself. Third, I did read the post hence when I said, "...degraded ejection fraction is not surprising, especially as time from surgical repair increases," basing that statement on the fact that she did have surgery and just quite possibly, she has a recurrence of the original problem. Fourth, yes she is 82 years old and it is not uncommon for someone of 80 y/o to have transplant or vad, one in particular, Carrol Shelby (of the car fame) had his done late 70's or early in his 80's. Fifth, I never suggested treating this patient in the field, merely speculating since brainstorming is always fun and educational. I never claim to know all the answers, hence I used the terms I suspect, not I know. Finally, as an elite member of the forum and fellow arizonan, I would have figured you would be more polite in posting rather than mocking someone who took an interest in your post, albeit dead (whatever the hell that means since the prior post was 10 days previous to mine).