[HSF] Compartment Syndrome

[Nasser F. Abou'Seada]

apparently that was not apparent from the description of cannulation. 

NFA

> -----Original Message-----
> From: openheart-l-bounces at lists.hsforum.com [mailto:openheart-l-
> bounces at lists.hsforum.com] On Behalf Of Ramaiah, Chandrashekar
> Sent: Monday, December 25, 2006 9:24 AM
> To: OpenHeart-L at lists.hsforum.com
> Subject: RE: [HSF] Compartment Syndrome
> 
> Arterial canula does not get in to the native artery.
> 
> 
> Chand
> 
> -----Original Message-----
> From: "Mehta Sukumar" <sukumarhmehta at yahoo.com>
> To: "OpenHeart-L at lists.hsforum.com" <OpenHeart-L at lists.hsforum.com>
> Sent: 12/25/06 8:29 AM
> Subject: Re: [HSF] Compartment Syndrome
> 
> Dear All,
>   Please excuse me for expressing a different view.
>   I fail to understand how sewing a graft to the side of the vessel ( and
then inserting
> the arterial canula through it in to the native artery and then retaining
there
> throughout the surgical procedure ) helps in avoiding distal limb
ischaemia.
>   Once your arterial canula enters the lumen of the native, recipient
artery ( through
> the graft, of course ) and is advanced some distance up the artery, the
situation is the
> same as what happens when you canulate the artery directly.
>   Yes, I agree that if you attach a graft, once you decanulate, closure of
the artery
> becomes a relatively easy and simple matter and probably also avoids
potential
> narrowing of the artery which is PROBABLY likely if the artery were
sutured directly
> instead ( when no graft was attached ).
>   Again, even assuming that direct repair of the artery is fraught with
the danger of
> distal limb ischaemia, I don't see much difficulty in avoiding this
potential narrowing
> at the "direct" arterial suture line. Meticulous suture takes care of this
apprehension.
> If the edges of the arteriotomy have been abraded very badly in attepts of
canulation
> and decanulation, it is possible to excise the edges and do an end-to-end
repair of the
> artery.
>   In short, I feel, the potential risk of distal limb ischaemia due to the
insertion and
> retention of the arterial canula should be the same, whether a graft is
used or not.
> The risk of potential distal limb ischaemia due to narrowing at the
arterial repair site (
> after decanulation ) may be a little less when a graft has been attached
to the side of
> the artery. Only my opinion.
>   Sukumar.
> 
> Cysmd613 at aol.com wrote:
>   I also sew an 8 mm Hemashield graft to the femoral artery if femoral
> cannulation is needed. It is very easy to do and avoids potential
complications of
> limb ischemia.
> 
> Carmi Stadlan
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