From donross at bigpond.com Wed Nov 1 10:50:32 2006 From: donross at bigpond.com (Donald Ross) Date: Tue Oct 31 18:51:39 2006 Subject: [HSF] complicationsincardiacsurgery Wiki In-Reply-To: <4546B5BA.1040503@gmail.com> References: <4546B5BA.1040503@gmail.com> Message-ID: <96CC6A81-BE16-496A-ACDC-6D11F1EDD488@bigpond.com> Dear Prasanna, Since the Wiki is in the public domain it will readily become a heavily bookmarked link for the litigation lawyers and perhaps may not be a good idea after all? What do the rest of you think? Don On 31/10/2006, at 1:32 PM, prasannasimha wrote: > Dear All, > I have given a request for the complicationsincardiacsurgery wiki. > The request will probably take 7 days to materialize. > If I get approval, I will give details and we will then be able to > create our Wiki. > I have registered it at Wikia. The original Wiki wiki. > Of created, I would request people to help me out. > All the people who would like to join as a moderator/ monitoring > team , please email me. > Prasanna > _______________________________________________ > OpenHeart-L mailing list > > Send postings to: > OpenHeart-L@lists.hsforum.com > > To UNSUBSCRIBE, to CHANGE email address, or to view archives: > http://mmp.cjp.com/mailman/listinfo/openheart-l > > All messages transmitted by the OpenHeart-L are subject to the > policies and disclaimers posted at: > http://www.hsforum.com/listdisclaim > ----------------------------------------- From benjamin.bidstrup at bigpond.com Wed Nov 1 11:31:46 2006 From: benjamin.bidstrup at bigpond.com (Ben Bidstrup) Date: Tue Oct 31 19:31:57 2006 Subject: [HSF] complicationsincardiacsurgery Wiki In-Reply-To: <96CC6A81-BE16-496A-ACDC-6D11F1EDD488@bigpond.com> References: <4546B5BA.1040503@gmail.com> <96CC6A81-BE16-496A-ACDC-6D11F1EDD488@bigpond.com> Message-ID: If the scum suckers realise that complications occur (or poor outcomes occur) and are related not to poor treatment but to the procedures and substrates with which we deal, maybe (ha ha ha ) they will be less inclined. It still comes down to a medical 'expert' providing a statement to the effect that the treatment was below standard. On the HSF and on the proposed site there is no indication of this. Besides, they can read any surgical textbook, and read the literature as well. Should we stop the publication of the next edition of Dr Khonsari's book for the same reason ? Count me in ! >Dear Prasanna, >Since the Wiki is in the public domain it will readily become a >heavily bookmarked link for the litigation lawyers and perhaps may >not be a good idea after all? >What do the rest of you think? >Don > >On 31/10/2006, at 1:32 PM, prasannasimha wrote: > >>Dear All, >>I have given a request for the complicationsincardiacsurgery wiki. >>The request will probably take 7 days to materialize. >>If I get approval, I will give details and we will then be able to >>create our Wiki. >>I have registered it at Wikia. The original Wiki wiki. >>Of created, I would request people to help me out. >>All the people who would like to join as a moderator/ monitoring >>team , please email me. >>Prasanna >>_______________________________________________ >>OpenHeart-L mailing list >> >>Send postings to: >>OpenHeart-L@lists.hsforum.com >> >>To UNSUBSCRIBE, to CHANGE email address, or to view archives: >>http://mmp.cjp.com/mailman/listinfo/openheart-l >> >>All messages transmitted by the OpenHeart-L are subject to the >>policies and disclaimers posted at: >>http://www.hsforum.com/listdisclaim >>----------------------------------------- >_______________________________________________ >OpenHeart-L mailing list > >Send postings to: >OpenHeart-L@lists.hsforum.com > >To UNSUBSCRIBE, to CHANGE email address, or to view archives: >http://mmp.cjp.com/mailman/listinfo/openheart-l > >All messages transmitted by the OpenHeart-L are subject to the >policies anddisclaimers posted at: >http://www.hsforum.com/listdisclaim >----------------------------------------- -- Ben Bidstrup FRACS FRCSEd FEBCTS Consultant Cardiothoracic Surgeon From prasannasimha at gmail.com Wed Nov 1 07:23:15 2006 From: prasannasimha at gmail.com (prasannasimha) Date: Tue Oct 31 20:59:38 2006 Subject: [HSF] complicationsincardiacsurgery Wiki In-Reply-To: <96CC6A81-BE16-496A-ACDC-6D11F1EDD488@bigpond.com> References: <4546B5BA.1040503@gmail.com> <96CC6A81-BE16-496A-ACDC-6D11F1EDD488@bigpond.com> Message-ID: <4547FE0B.3000508@gmail.com> The opening statement will be that this will not and shall not be considered as legal or medical advice. Also since this documents anyway "complications inherent to cardiac surgery" this would work in the reverse way !! The initial statement will remind readers that this is a Wiki and that while we may allow changes to be done only by "memebers " its open source nature would allow changes which may have to be approved. Approved changes will be kept fixed and non changeable. I am also thinking of making all changes to have an additional email id added to keep a track. I am also nw to this and we will have to make changes as we go on . What we should achieve is a hands down practical approach to a particular problem and by no menas hsould these be construed as "standards of care" or guidelines. This will be spelt out in the beginning that we shall call these "unguidlines" like the famous "uncyclopedia !!! This will be useful to those who can make sense of the data. If we have email id's if anyone wants to check out with another person wrt a problem he can do so in priovate and could add info gained by that to the wiki. I am using the Model of GANFYD which doesn't allow easily changes on the wiki. Prasanna Donald Ross wrote: > Dear Prasanna, > Since the Wiki is in the public domain it will readily become a > heavily bookmarked link for the litigation lawyers and perhaps may not > be a good idea after all? > What do the rest of you think? > Don > > On 31/10/2006, at 1:32 PM, prasannasimha wrote: > >> Dear All, >> I have given a request for the complicationsincardiacsurgery wiki. >> The request will probably take 7 days to materialize. >> If I get approval, I will give details and we will then be able to >> create our Wiki. >> I have registered it at Wikia. The original Wiki wiki. >> Of created, I would request people to help me out. >> All the people who would like to join as a moderator/ monitoring team >> , please email me. >> Prasanna >> _______________________________________________ >> OpenHeart-L mailing list >> >> Send postings to: >> OpenHeart-L@lists.hsforum.com >> >> To UNSUBSCRIBE, to CHANGE email address, or to view archives: >> http://mmp.cjp.com/mailman/listinfo/openheart-l >> >> All messages transmitted by the OpenHeart-L are subject to the >> policies and disclaimers posted at: >> http://www.hsforum.com/listdisclaim >> ----------------------------------------- > _______________________________________________ > OpenHeart-L mailing list > > Send postings to: > OpenHeart-L@lists.hsforum.com > > To UNSUBSCRIBE, to CHANGE email address, or to view archives: > http://mmp.cjp.com/mailman/listinfo/openheart-l > > All messages transmitted by the OpenHeart-L are subject to the > policies anddisclaimers posted at: > http://www.hsforum.com/listdisclaim > ----------------------------------------- > > > --No virus found in this incoming message. > Checked by AVG Free Edition. > Version: 7.1.409 / Virus Database: 268.13.21/509 - Release Date: > 10/31/2006 > > From prasannasimha at gmail.com Wed Nov 1 07:39:25 2006 From: prasannasimha at gmail.com (psimha) Date: Tue Oct 31 21:09:34 2006 Subject: [HSF] complicationsincardiacsurgery Wiki In-Reply-To: <96CC6A81-BE16-496A-ACDC-6D11F1EDD488@bigpond.com> References: <4546B5BA.1040503@gmail.com> <96CC6A81-BE16-496A-ACDC-6D11F1EDD488@bigpond.com> Message-ID: <454801D5.2030603@sify.com> An eg in Pediheart.net With over 2,000 members, PediHeartNet is a PUBLIC FORUM. No one can control what happens to information posted on PediHeartNet. Discussion on PediHeartNet is not intended and should not be construed as a consultancy nor as advice on a particular patient or patient care. It is a forum for the dissemination and development of general medical knowledge. Please do not rely on comments posted on PediHeartNet to make specific patient care decisions, and do not include printed versions of these comments in any patient's medical record. PediHeartNet is a vehicle designated to facilitate communication between private individuals and improve the care of children with heart disease. It does not monitor, moderate, judge, censor or promote the content of the messages. Individuals posting messages on PediHeartNet bear the sole responsibility for the content of their messages. The persons USING the information gained on PediHeartNet have the sole responsibility for any consequences or damages resulting from their action. 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When discussing cases, it is the sole responsibility of the PediHeartNet members to ensure that no identifying information about specific patients is revealed. Donald Ross wrote: > Dear Prasanna, > Since the Wiki is in the public domain it will readily become a > heavily bookmarked link for the litigation lawyers and perhaps may not > be a good idea after all? > What do the rest of you think? > Don > > On 31/10/2006, at 1:32 PM, prasannasimha wrote: > >> Dear All, >> I have given a request for the complicationsincardiacsurgery wiki. >> The request will probably take 7 days to materialize. >> If I get approval, I will give details and we will then be able to >> create our Wiki. >> I have registered it at Wikia. The original Wiki wiki. >> Of created, I would request people to help me out. >> All the people who would like to join as a moderator/ monitoring team >> , please email me. >> Prasanna >> _______________________________________________ >> OpenHeart-L mailing list >> >> Send postings to: >> OpenHeart-L@lists.hsforum.com >> >> To UNSUBSCRIBE, to CHANGE email address, or to view archives: >> http://mmp.cjp.com/mailman/listinfo/openheart-l >> >> All messages transmitted by the OpenHeart-L are subject to the >> policies and disclaimers posted at: >> http://www.hsforum.com/listdisclaim >> ----------------------------------------- > _______________________________________________ > OpenHeart-L mailing list > > Send postings to: > OpenHeart-L@lists.hsforum.com > > To UNSUBSCRIBE, to CHANGE email address, or to view archives: > http://mmp.cjp.com/mailman/listinfo/openheart-l > > All messages transmitted by the OpenHeart-L are subject to the > policies anddisclaimers posted at: > http://www.hsforum.com/listdisclaim > ----------------------------------------- > > > --No virus found in this incoming message. > Checked by AVG Free Edition. > Version: 7.1.409 / Virus Database: 268.13.21/509 - Release Date: > 10/31/2006 > > From donross at bigpond.com Wed Nov 1 13:20:27 2006 From: donross at bigpond.com (Donald Ross) Date: Tue Oct 31 21:21:35 2006 Subject: [HSF] complicationsincardiacsurgery Wiki In-Reply-To: <4547FE0B.3000508@gmail.com> References: <4546B5BA.1040503@gmail.com> <96CC6A81-BE16-496A-ACDC-6D11F1EDD488@bigpond.com> <4547FE0B.3000508@gmail.com> Message-ID: I am converted Prasanna, as you say a list of actual unavoidable complications inherent to the speciality would give is a chance to refer it potential patients and if they signed a declaration that they had read and understood it it may be medico-legal leg up. Don On 01/11/2006, at 12:53 PM, prasannasimha wrote: > The opening statement will be that this will not and shall not be > considered as legal or medical advice. Also since this documents > anyway "complications inherent to cardiac surgery" this would work > in the reverse way !! > The initial statement will remind readers that this is a Wiki and > that while we may allow changes to be done only by "memebers " its > open source nature would allow changes which may have to be > approved. Approved changes will be kept fixed and non changeable. > I am also thinking of making all changes to have an additional > email id added to keep a track. I am also nw to this and we will > have to make changes as we go on . > What we should achieve is a hands down practical approach to a > particular problem and by no menas hsould these be construed as > "standards of care" or guidelines. This will be spelt out in the > beginning that we shall call these "unguidlines" like the famous > "uncyclopedia !!! This will be useful to those who can make sense > of the data. If we have email id's if anyone wants to check out > with another person wrt a problem he can do so in priovate and > could add info gained by that to the wiki. I am using the Model of > GANFYD which doesn't allow easily changes on the wiki. > Prasanna > Donald Ross wrote: >> Dear Prasanna, >> Since the Wiki is in the public domain it will readily become a >> heavily bookmarked link for the litigation lawyers and perhaps may >> not be a good idea after all? >> What do the rest of you think? >> Don >> >> On 31/10/2006, at 1:32 PM, prasannasimha wrote: >> >>> Dear All, >>> I have given a request for the complicationsincardiacsurgery wiki. >>> The request will probably take 7 days to materialize. >>> If I get approval, I will give details and we will then be able >>> to create our Wiki. >>> I have registered it at Wikia. The original Wiki wiki. >>> Of created, I would request people to help me out. >>> All the people who would like to join as a moderator/ monitoring >>> team , please email me. >>> Prasanna >>> _______________________________________________ >>> OpenHeart-L mailing list >>> >>> Send postings to: >>> OpenHeart-L@lists.hsforum.com >>> >>> To UNSUBSCRIBE, to CHANGE email address, or to view archives: >>> http://mmp.cjp.com/mailman/listinfo/openheart-l >>> >>> All messages transmitted by the OpenHeart-L are subject to the >>> policies and disclaimers posted at: >>> http://www.hsforum.com/listdisclaim >>> ----------------------------------------- >> _______________________________________________ >> OpenHeart-L mailing list >> >> Send postings to: >> OpenHeart-L@lists.hsforum.com >> >> To UNSUBSCRIBE, to CHANGE email address, or to view archives: >> http://mmp.cjp.com/mailman/listinfo/openheart-l >> >> All messages transmitted by the OpenHeart-L are subject to the >> policies anddisclaimers posted at: >> http://www.hsforum.com/listdisclaim >> ----------------------------------------- >> >> >> --No virus found in this incoming message. >> Checked by AVG Free Edition. >> Version: 7.1.409 / Virus Database: 268.13.21/509 - Release Date: >> 10/31/2006 >> >> > > _______________________________________________ > OpenHeart-L mailing list > > Send postings to: > OpenHeart-L@lists.hsforum.com > > To UNSUBSCRIBE, to CHANGE email address, or to view archives: > http://mmp.cjp.com/mailman/listinfo/openheart-l > > All messages transmitted by the OpenHeart-L are subject to the > policies and disclaimers posted at: > http://www.hsforum.com/listdisclaim > ----------------------------------------- From donross at bigpond.com Wed Nov 1 13:21:20 2006 From: donross at bigpond.com (Donald Ross) Date: Tue Oct 31 21:21:36 2006 Subject: [HSF] agency for health care and research AHRQ In-Reply-To: <4546B5BA.1040503@gmail.com> References: <4546B5BA.1040503@gmail.com> Message-ID: Here is an interesting release from this mob http://www.ahrq.gov/news/press/pr2006/offpumppr.htm From nkkejriwal at gmail.com Wed Nov 1 16:12:29 2006 From: nkkejriwal at gmail.com (nand kejriwal) Date: Tue Oct 31 22:12:32 2006 Subject: [HSF] Pleural effusion following peritoneal dialysis In-Reply-To: <196767B5-5FC7-48A7-9BC7-645B7045BCE1@charter.net> References: <196767B5-5FC7-48A7-9BC7-645B7045BCE1@charter.net> Message-ID: Ed No, she did no have a catamenial pneumothorax. However, I forgot to mention that she is on steroids for sarcoid. It is currently down to 7.5 mg a day. I guess, that reduces the chance of lung sticking up the chest wall. nand On 10/31/06, Edward Bender wrote: > > has she ever had a catamenial pneumothorax? > > Ed Bender, MD > > On Oct 30, 2006, at 1:01 AM, nand kejriwal wrote: > > > Dear members > > > > I have been referred a 65 year old obese diabetic lady with end- > > stage renal > > failure. She lives in a remote place and does not want to travel to > > the > > nearest haemodialysis centre. When she was being taught home > > peritoneal > > dialysis, it was discovered that she developed pleural effusion > > each time > > peritoneal dialysis was carried out. I am planning to perform video- > > assisted > > talc pleurodesis. Does any member have experience with this > > condition? Do I > > have to search for a pleuro-peritoneal communication during > > thoracoscopy? > > One of the reports mentioned that the diaphragmatic defects might be > > microscopic and difficult to localise even at autopsy. Can we > > delineate the > > communication by special imaging? > > > > Thanks > > Nand > > > > > >> > > _______________________________________________ > > OpenHeart-L mailing list > > > > Send postings to: > > OpenHeart-L@lists.hsforum.com > > > > To UNSUBSCRIBE, to CHANGE email address, or to view archives: > > http://mmp.cjp.com/mailman/listinfo/openheart-l > > > > All messages transmitted by the OpenHeart-L are subject to the > > policies and disclaimers posted at: > > http://www.hsforum.com/listdisclaim > > ----------------------------------------- > _______________________________________________ > OpenHeart-L mailing list > > Send postings to: > OpenHeart-L@lists.hsforum.com > > To UNSUBSCRIBE, to CHANGE email address, or to view archives: > http://mmp.cjp.com/mailman/listinfo/openheart-l > > All messages transmitted by the OpenHeart-L are subject to the policies > and > disclaimers posted at: > http://www.hsforum.com/listdisclaim > ----------------------------------------- > From nkkejriwal at gmail.com Wed Nov 1 16:16:39 2006 From: nkkejriwal at gmail.com (nand kejriwal) Date: Tue Oct 31 22:16:43 2006 Subject: [HSF] Pleural effusion following peritoneal dialysis In-Reply-To: References: Message-ID: Thanks Ed Would you simply do a talc pleurodesis or should I mechanically abrade the parietal pleura at the same time? I am a bit concerned about the bleeding in view of uraemia. Nand On 10/31/06, DukeB60@aol.com wrote: > > Nand, > I would echo the opinion of those who suggest these communications are > hard, if not impossible, to find. The hole can indeed be microscopic and > not > only hard to find but very difficult to close effectively. I think some > people just can't do peritoneal dialysis for this reason. Of coarse, you > can try > to find a defect via VATS by instillation of methylene blue in the > dialysate > while you are looking with the scope but even then be prepared to fail. > > > Ed > > Edward P. Raines, M.D., J.D. > BryanLGH Cardiothoracic Surgery > BryanLGH Medical Center East > 1600 South 48th Str. > Lincoln, Nebraska 68506 > Office: 402-481-8430 > Cell: 402-730-9242 > Fax: 402-481-8429 > _______________________________________________ > OpenHeart-L mailing list > > Send postings to: > OpenHeart-L@lists.hsforum.com > > To UNSUBSCRIBE, to CHANGE email address, or to view archives: > http://mmp.cjp.com/mailman/listinfo/openheart-l > > All messages transmitted by the OpenHeart-L are subject to the policies > and > disclaimers posted at: > http://www.hsforum.com/listdisclaim > ----------------------------------------- > From nfaabouseada at gmail.com Wed Nov 1 00:57:04 2006 From: nfaabouseada at gmail.com (Nasser F. Abou'Seada) Date: Wed Nov 1 00:57:16 2006 Subject: [HSF] complicationsincardiacsurgery Wiki In-Reply-To: <96CC6A81-BE16-496A-ACDC-6D11F1EDD488@bigpond.com> Message-ID: <000601c6fd7a$908301a0$0801a8c0@OEM> I concur with Don ... is there a way to make it a private domain ? .. not necessarily a wiki one ..! NFA > From: Donald Ross > Dear Prasanna, > Since the Wiki is in the public domain it will readily become a > heavily bookmarked link for the litigation lawyers and perhaps may > not be a good idea after all? > What do the rest of you think? > Don > > On 31/10/2006, at 1:32 PM, prasannasimha wrote: > > > Dear All, > > I have given a request for the complicationsincardiacsurgery wiki. > > The request will probably take 7 days to materialize. > > If I get approval, I will give details and we will then be able to > > create our Wiki. > > I have registered it at Wikia. The original Wiki wiki. > > Of created, I would request people to help me out. > > All the people who would like to join as a moderator/ monitoring > > team , please email me. > > Prasanna > > _______________________________________________ > > OpenHeart-L mailing list > > > > Send postings to: > > OpenHeart-L@lists.hsforum.com > > > > To UNSUBSCRIBE, to CHANGE email address, or to view archives: > > http://mmp.cjp.com/mailman/listinfo/openheart-l > > > > All messages transmitted by the OpenHeart-L are subject to the > > policies and disclaimers posted at: > > http://www.hsforum.com/listdisclaim > > ----------------------------------------- > _______________________________________________ > OpenHeart-L mailing list > > Send postings to: > OpenHeart-L@lists.hsforum.com > > To UNSUBSCRIBE, to CHANGE email address, or to view archives: > http://mmp.cjp.com/mailman/listinfo/openheart-l > > All messages transmitted by the OpenHeart-L are subject to the policies and > disclaimers posted at: > http://www.hsforum.com/listdisclaim > ----------------------------------------- From prasannasimha at gmail.com Wed Nov 1 11:35:23 2006 From: prasannasimha at gmail.com (psimha) Date: Wed Nov 1 01:12:41 2006 Subject: [HSF] complicationsincardiacsurgery Wiki In-Reply-To: <000601c6fd7a$908301a0$0801a8c0@OEM> References: <000601c6fd7a$908301a0$0801a8c0@OEM> Message-ID: <45483923.9080302@sify.com> Nasser - knowledge flow cannot be suppressed - it can be accessed by those who are interested and also determined to get it !! The wiki format will allow interested people to easily access it. As I said there will be appropriate disclaimers and references to it in every page. here are whole text books to feed the lawyers grist but remember no textbook or document can be admitted without a human collaboration in the evidence act except probably in some countries holy books but even these have to be quoted and concurred by a human interpreter. Remember that the Internet precisely has benefited humanity by its "open access". There will always be people misusing it as is everything else in life. At present Dr Bidstrup and Faisal Cheema have agreed to help in moderators. Don has too agree to the idea. I hope I get the approval from Wikia and if it goes through we can start. Proably we can start with step 1 Patient preparation step 2 Induction of the patient Step 3 Cannulation for CPB Prasanna Nasser F. Abou'Seada wrote: > I concur with Don ... is there a way to make it a private domain ? .. not > necessarily a wiki one ..! > > > NFA > > >> From: Donald Ross >> Dear Prasanna, >> Since the Wiki is in the public domain it will readily become a >> heavily bookmarked link for the litigation lawyers and perhaps may >> not be a good idea after all? >> What do the rest of you think? >> Don >> >> On 31/10/2006, at 1:32 PM, prasannasimha wrote: >> >> >>> Dear All, >>> I have given a request for the complicationsincardiacsurgery wiki. >>> The request will probably take 7 days to materialize. >>> If I get approval, I will give details and we will then be able to >>> create our Wiki. >>> I have registered it at Wikia. The original Wiki wiki. >>> Of created, I would request people to help me out. >>> All the people who would like to join as a moderator/ monitoring >>> team , please email me. >>> Prasanna >>> _______________________________________________ >>> OpenHeart-L mailing list >>> >>> Send postings to: >>> OpenHeart-L@lists.hsforum.com >>> >>> To UNSUBSCRIBE, to CHANGE email address, or to view archives: >>> http://mmp.cjp.com/mailman/listinfo/openheart-l >>> >>> All messages transmitted by the OpenHeart-L are subject to the >>> policies and disclaimers posted at: >>> http://www.hsforum.com/listdisclaim >>> ----------------------------------------- >>> >> _______________________________________________ >> OpenHeart-L mailing list >> >> Send postings to: >> OpenHeart-L@lists.hsforum.com >> >> To UNSUBSCRIBE, to CHANGE email address, or to view archives: >> http://mmp.cjp.com/mailman/listinfo/openheart-l >> >> All messages transmitted by the OpenHeart-L are subject to the policies >> > and > >> disclaimers posted at: >> http://www.hsforum.com/listdisclaim >> ----------------------------------------- >> > > _______________________________________________ > OpenHeart-L mailing list > > Send postings to: > OpenHeart-L@lists.hsforum.com > > To UNSUBSCRIBE, to CHANGE email address, or to view archives: > http://mmp.cjp.com/mailman/listinfo/openheart-l > > All messages transmitted by the OpenHeart-L are subject to the policies and > disclaimers posted at: > http://www.hsforum.com/listdisclaim > ----------------------------------------- > > > From benjamin.bidstrup at bigpond.com Wed Nov 1 18:04:36 2006 From: benjamin.bidstrup at bigpond.com (Ben Bidstrup) Date: Wed Nov 1 02:04:47 2006 Subject: [HSF] Re: Favorite cardiac surgical myths In-Reply-To: <20061101052808.13612.qmail@web81603.mail.mud.yahoo.com> References: <20061101052808.13612.qmail@web81603.mail.mud.yahoo.com> Message-ID: Use of his definitions for discussing new therapies now makes it a little hard to work out which treatment is effective. >BTW...Are not Dr. Cox's categories of afib: intermittent or >permanent? Is that ironic, prescience, hubris, or what? Maybe >clinically more real and relevant would be primary and unrecognized, >unlikely, likely, always and (hopefully) never again which is the >same as unlikely ( or unrecognized). Tea ----- Original Message ---- >From: "rwmfglycar@aol.com" To: >OpenHeart-L@lists.hsforum.com Sent: Monday, October 30, 2006 >11:05:16 AM Subject: Re: [HSF] Re: Favorite cardiac surgical myths >There are many How about these: Tricuspid insufficiency accompanying >left sided disease wikk get better by itself Cardiologists like this >one: AS with an ejection fraction of 15% is too sick for open heart >surgery Endocarditis must be treated with antibiotics for 6 weeks >before surgery Bob -----Original Message----- From: >prasannasimha@gmail.com To: OpenHeart-L@lists.hsforum.com Cc: >OpenHeart-L@hsforum.com Sent: Sat, 28 Oct 2006 11:27 PM Subject: Re: >[HSF] Re: Favorite cardiac surgical myths Similar thing with low >EF's - Low EF MR and AR can never recover !! Another myth >-Isoprenaline works well for Fallot's post operatively. One more >myth - Afib is "permanent" and then came James Cox and his Maze. And >one of the biggest myths - high dose "ruthless adrenaline " Prasanna >CSPassik@aol.com wrote: > In thinking about the so-called >"un-clampable" aorta, I throw out for the > member's consideration >something I would enjoy seeing on this list- everyone > should post >their favorite cardiac surgical myth- those things that we were > >taught were impossible but somehow we do anyway and usually get >away > with-sometimes with impunity. I think this would be more >popular than everyone's > favorite disaster-somehow our >psychological powers of repression makes these cases > much harder >to recall, but just become part of the hard-won experience file. > >Cary Passik > _______________________________________________ > >OpenHeart-L mailing list > > Send postings to: > >OpenHeart-L@lists.hsforum.com > > To UNSUBSCRIBE, to CHANGE email >address, or to view archives: > >http://mmp.cjp.com/mailman/listinfo/openheart-l > > All messages >transmitted by the OpenHeart-L are subject to the policies and > >disclaimers posted at: > http://www.hsforum.com/listdisclaim > >----------------------------------------- > > > >_______________________________________________ OpenHeart-L mailing >list Send postings to: OpenHeart-L@lists.hsforum.com To UNSUBSCRIBE, >to CHANGE email address, or to view archives: >http://mmp.cjp.com/mailman/listinfo/openheart-l All messages >transmitted by the OpenHeart-L are subject to the policies and >disclaimers posted at: http://www.hsforum.com/listdisclaim >----------------------------------------- >________________________________________________________________________ >Check out the new AOL. Most comprehensive set of free safety and >security tools, free access to millions of high-quality videos from >across the web, free AOL Mail and more. >_______________________________________________ OpenHeart-L mailing >list Send postings to: OpenHeart-L@lists.hsforum.com To UNSUBSCRIBE, >to CHANGE email address, or to view archives: >http://mmp.cjp.com/mailman/listinfo/openheart-l All messages >transmitted by the OpenHeart-L are subject to the policies and >disclaimers posted at: http://www.hsforum.com/listdisclaim >----------------------------------------- >_______________________________________________ >OpenHeart-L mailing list > >Send postings to: > OpenHeart-L@lists.hsforum.com > >To UNSUBSCRIBE, to CHANGE email address, or to view archives: >http://mmp.cjp.com/mailman/listinfo/openheart-l > >All messages transmitted by the OpenHeart-L are subject to the policies and >disclaimers posted at: >http://www.hsforum.com/listdisclaim >----------------------------------------- -- Ben Bidstrup FRACS FRCSEd FEBCTS Consultant Cardiothoracic Surgeon From giulio.rizzoli at unipd.it Wed Nov 1 10:04:04 2006 From: giulio.rizzoli at unipd.it (Giulio Rizzoli) Date: Wed Nov 1 03:57:37 2006 Subject: =?iso-8859-1?Q?Re:_AW:_AW:_[HSF]_It=B4s_the_cord,_...Clinton?= says In-Reply-To: <20061031125856.AD45572BA1@mrzs235220.medizin.uni-leipzig.d e> References: <454745C2.9060406@gmail.com> <20061031125856.AD45572BA1@mrzs235220.medizin.uni-leipzig.de> Message-ID: <7.0.0.16.1.20061101094139.01fb7cb8@unipd.it> The concern about the chord is right, because paraplegia is the most dreadfull complication for any patient, nonetheless I have always been teaced that 30' are pretty safe if you repair an isthmic transection with the Cooley "clamp and go" technique (in the nomogram reported by Kirklin's book 2?nd edition, on page 1710 the probability is about 10%). Nonetheless this data are for normothermia! If You runa perfusion at 28? prior to circulatory arrest you should have the added protection of some cooling. Furthermore if the origin of the subclavian artery is snared, while perfusing both carotid arteries at 28? , there must be perfusion of the chord by the subclavian collateral circulation through vertebrals, mammary, intercostal arteries, aso. The numbers you report are the extimated safe protection of the brain during circulatory arrest ! I was wondering if there are in the litterature estimates of the safe time of circulatory arrest in the lower body (Kidney liver and chord) while running selective cerebral perfusion with the Kazui technique. In my "unfortunately too small" experience it was safe up to 35', plenty of time to carefully prepare an open aortic arch anastomosis. Giulio Rizzoli >What I tried to say was that, Prasanna, the cord, that ist he question . >Hamlet >-----Urspr?ngliche Nachricht----- >Von: openheart-l-bounces@lists.hsforum.com >[mailto:openheart-l-bounces@lists.hsforum.com] Im Auftrag von prasannasimha >Gesendet: Dienstag, 31. Oktober 2006 13:47 >An: OpenHeart-L@lists.hsforum.com >Betreff: Re: AW: [HSF] porcellan aorta > >My main concern with this trend to "normothermic" brain surgery is that >we are not protecting the cord. This can lead to unacceptable paraplegia >if lower body perfusion is interrupted. This may not be so much of a >concern if lower body perfusion is maintained. >TCA at 18 deg - 45 min >TCA at 28 Deg 15 min >TCA at 32 Deg - 7 min are probably estimates of TCA with negligible >complications. Beyond this there will be a progressive increase in >complications. > >Prasanna > >Dr. Roberto Battellini wrote: > > No, no data. I confess I am still very conservative, remember the people >of > > Mount Sinai doing it at 18 grades! Remember the book of Edmunds in >ctesnet. > > So for me, 20 Degrees Oesophagus was courageous.But the patient is now at > > normal station!. > > > > You opened a very nice question for the HSF, let?s do together. > > At which oesophagus-rectal, etc temperature do the members make total > > circulatory arrest without any complication!!!(including paraplegia) , and > > how long is it sure. > > > > Roberto > > > > > > -----Urspr?ngliche Nachricht----- > > Von: openheart-l-bounces@lists.hsforum.com > > [mailto:openheart-l-bounces@lists.hsforum.com] Im Auftrag von Giulio >Rizzoli > > Gesendet: Montag, 30. Oktober 2006 09:11 > > An: OpenHeart-L@lists.hsforum.com > > Betreff: Re: [HSF] porcellan aorta > > > > Beautiful picture ! Why 20? temperature ? > > At 27? you can arrest the brain circulation > > safely for 10 m'. Plenty of time to cannulate the > > left carotid artery , occlude the left subclavian > > e completely rperfuse the brain. > > I think the question is : How long will normal > > kidney and liver tolerate ischemia at 27? ? Do You have data on it? > > Giulio Rizzoli > > > > > > > > > >> We cannulated the axillary artery and went to 20 degrees oesophagus. . > >> Roberto and Giuseppe, Leipzig > >> > >> ------------------------------------------------------------------------ > >> Las mejores tiendas, los precios mas bajos, > >> entregas en todo el mundo, YupiMSN Compras: Haz > >> clic aqu?... > >> > >> > >> > >> _______________________________________________ > >> OpenHeart-L mailing list > >> > >> Send postings to: > >> OpenHeart-L@lists.hsforum.com > >> > >> To UNSUBSCRIBE, to CHANGE email address, or to view archives: > >> http://mmp.cjp.com/mailman/listinfo/openheart-l > >> > >> All messages transmitted by the OpenHeart-L are subject to the policies >and > >> disclaimers posted at: > >> http://www.hsforum.com/listdisclaim > >> ----------------------------------------- > >> > > > > Giulio Rizzoli MD FETCS > > Cardiochirurgia Padova > > tel. 049 821-2408 > > fax 049 821-2409 > > e-mail giulio.rizzoli@unipd.it > > > > > > _______________________________________________ > > OpenHeart-L mailing list > > > > Send postings to: > > OpenHeart-L@lists.hsforum.com > > > > To UNSUBSCRIBE, to CHANGE email address, or to view archives: > > http://mmp.cjp.com/mailman/listinfo/openheart-l > > > > All messages transmitted by the OpenHeart-L are subject to the policies >and > > disclaimers posted at: > > http://www.hsforum.com/listdisclaim > > ----------------------------------------- > > > > _______________________________________________ > > OpenHeart-L mailing list > > > > Send postings to: > > OpenHeart-L@lists.hsforum.com > > > > To UNSUBSCRIBE, to CHANGE email address, or to view archives: > > http://mmp.cjp.com/mailman/listinfo/openheart-l > > > > All messages transmitted by the OpenHeart-L are subject to the policies >and > > disclaimers posted at: > > http://www.hsforum.com/listdisclaim > > ----------------------------------------- > > > > >_______________________________________________ >OpenHeart-L mailing list > >Send postings to: > OpenHeart-L@lists.hsforum.com > >To UNSUBSCRIBE, to CHANGE email address, or to view archives: >http://mmp.cjp.com/mailman/listinfo/openheart-l > >All messages transmitted by the OpenHeart-L are subject to the policies and >disclaimers posted at: >http://www.hsforum.com/listdisclaim >----------------------------------------- > >_______________________________________________ >OpenHeart-L mailing list > >Send postings to: > OpenHeart-L@lists.hsforum.com > >To UNSUBSCRIBE, to CHANGE email address, or to view archives: >http://mmp.cjp.com/mailman/listinfo/openheart-l > >All messages transmitted by the OpenHeart-L are subject to the policies and >disclaimers posted at: >http://www.hsforum.com/listdisclaim >----------------------------------------- Giulio Rizzoli MD FETCS Cardiochirurgia Padova tel. 049 821-2408 fax 049 821-2409 e-mail giulio.rizzoli@unipd.it From prasannasimha at gmail.com Wed Nov 1 14:46:28 2006 From: prasannasimha at gmail.com (prasannasimha) Date: Wed Nov 1 04:16:44 2006 Subject: AW: AW: [HSF] =?ISO-8859-1?Q?It=B4s_the_cord=2C_=2E=2E?= =?ISO-8859-1?Q?=2EClinton_says?= In-Reply-To: <7.0.0.16.1.20061101094139.01fb7cb8@unipd.it> References: <454745C2.9060406@gmail.com> <20061031125856.AD45572BA1@mrzs235220.medizin.uni-leipzig.de> <7.0.0.16.1.20061101094139.01fb7cb8@unipd.it> Message-ID: <454865EC.8050509@gmail.com> Yes, what I was saying was for the brain though I do not think the cord is very resistant to true Ischemia (Clamping the cord involves some collateral flow . Regarding Kidneys and Liver , they cannot be better than the time for transplantation. Unfortunately we do not flush perfuse these organs and isolate them so the times will be less. I have used whole body retroperfusion just to keep these organs cool and I do not think they really provide nutritive flow due to valves in the lower body venous circuit. Incidentally I missed out the Clinton bit can somebody explain it to me ? Prasanna Giulio Rizzoli wrote: > The concern about the chord is right, because paraplegia is the most > dreadfull complication for any patient, nonetheless I have always been > teaced that 30' are pretty safe if you repair an isthmic transection > with the Cooley "clamp and go" technique (in the nomogram reported by > Kirklin's book 2?nd edition, on page 1710 the probability is about 10%). > Nonetheless this data are for normothermia! > If You runa perfusion at 28? prior to circulatory arrest you should > have the added protection of some cooling. > Furthermore if the origin of the subclavian artery is snared, while > perfusing both carotid arteries at 28? , there must be perfusion of > the chord by the subclavian collateral circulation through vertebrals, > mammary, intercostal arteries, aso. > The numbers you report are the extimated safe protection of the brain > during circulatory arrest ! > I was wondering if there are in the litterature estimates of the safe > time of circulatory arrest in the lower body (Kidney liver and chord) > while running selective cerebral perfusion with the Kazui technique. > In my "unfortunately too small" experience it was safe up to 35', > plenty of time to carefully prepare an open aortic arch anastomosis. > Giulio Rizzoli > > > >> What I tried to say was that, Prasanna, the cord, that ist he question . >> Hamlet >> -----Urspr?ngliche Nachricht----- >> Von: openheart-l-bounces@lists.hsforum.com >> [mailto:openheart-l-bounces@lists.hsforum.com] Im Auftrag von >> prasannasimha >> Gesendet: Dienstag, 31. Oktober 2006 13:47 >> An: OpenHeart-L@lists.hsforum.com >> Betreff: Re: AW: [HSF] porcellan aorta >> >> My main concern with this trend to "normothermic" brain surgery is that >> we are not protecting the cord. This can lead to unacceptable paraplegia >> if lower body perfusion is interrupted. This may not be so much of a >> concern if lower body perfusion is maintained. >> TCA at 18 deg - 45 min >> TCA at 28 Deg 15 min >> TCA at 32 Deg - 7 min are probably estimates of TCA with negligible >> complications. Beyond this there will be a progressive increase in >> complications. >> >> Prasanna >> >> Dr. Roberto Battellini wrote: >> > No, no data. I confess I am still very conservative, remember the >> people >> of >> > Mount Sinai doing it at 18 grades! Remember the book of Edmunds in >> ctesnet. >> > So for me, 20 Degrees Oesophagus was courageous.But the patient is >> now at >> > normal station!. >> > >> > You opened a very nice question for the HSF, let?s do together. >> > At which oesophagus-rectal, etc temperature do the members make total >> > circulatory arrest without any complication!!!(including >> paraplegia) , and >> > how long is it sure. >> > >> > Roberto >> > >> > >> > -----Urspr?ngliche Nachricht----- >> > Von: openheart-l-bounces@lists.hsforum.com >> > [mailto:openheart-l-bounces@lists.hsforum.com] Im Auftrag von Giulio >> Rizzoli >> > Gesendet: Montag, 30. Oktober 2006 09:11 >> > An: OpenHeart-L@lists.hsforum.com >> > Betreff: Re: [HSF] porcellan aorta >> > >> > Beautiful picture ! Why 20? temperature ? >> > At 27? you can arrest the brain circulation >> > safely for 10 m'. Plenty of time to cannulate the >> > left carotid artery , occlude the left subclavian >> > e completely rperfuse the brain. >> > I think the question is : How long will normal >> > kidney and liver tolerate ischemia at 27? ? Do You have data on it? >> > Giulio Rizzoli >> > >> > >> > >> > >> >> We cannulated the axillary artery and went to 20 degrees >> oesophagus. . >> >> Roberto and Giuseppe, Leipzig >> >> >> >> >> ------------------------------------------------------------------------ >> >> Las mejores tiendas, los precios mas bajos, >> >> entregas en todo el mundo, YupiMSN Compras: Haz >> >> clic aqu?... >> >> >> >> >> >> >> >> _______________________________________________ >> >> OpenHeart-L mailing list >> >> >> >> Send postings to: >> >> OpenHeart-L@lists.hsforum.com >> >> >> >> To UNSUBSCRIBE, to CHANGE email address, or to view archives: >> >> http://mmp.cjp.com/mailman/listinfo/openheart-l >> >> >> >> All messages transmitted by the OpenHeart-L are subject to the >> policies >> and >> >> disclaimers posted at: >> >> http://www.hsforum.com/listdisclaim >> >> ----------------------------------------- >> >> >> > >> > Giulio Rizzoli MD FETCS >> > Cardiochirurgia Padova >> > tel. 049 821-2408 >> > fax 049 821-2409 >> > e-mail giulio.rizzoli@unipd.it >> > >> > >> > _______________________________________________ >> > OpenHeart-L mailing list >> > >> > Send postings to: >> > OpenHeart-L@lists.hsforum.com >> > >> > To UNSUBSCRIBE, to CHANGE email address, or to view archives: >> > http://mmp.cjp.com/mailman/listinfo/openheart-l >> > >> > All messages transmitted by the OpenHeart-L are subject to the >> policies >> and >> > disclaimers posted at: >> > http://www.hsforum.com/listdisclaim >> > ----------------------------------------- >> > >> > _______________________________________________ >> > OpenHeart-L mailing list >> > >> > Send postings to: >> > OpenHeart-L@lists.hsforum.com >> > >> > To UNSUBSCRIBE, to CHANGE email address, or to view archives: >> > http://mmp.cjp.com/mailman/listinfo/openheart-l >> > >> > All messages transmitted by the OpenHeart-L are subject to the >> policies >> and >> > disclaimers posted at: >> > http://www.hsforum.com/listdisclaim >> > ----------------------------------------- >> > >> > >> _______________________________________________ >> OpenHeart-L mailing list >> >> Send postings to: >> OpenHeart-L@lists.hsforum.com >> >> To UNSUBSCRIBE, to CHANGE email address, or to view archives: >> http://mmp.cjp.com/mailman/listinfo/openheart-l >> >> All messages transmitted by the OpenHeart-L are subject to the >> policies and >> disclaimers posted at: >> http://www.hsforum.com/listdisclaim >> ----------------------------------------- >> >> _______________________________________________ >> OpenHeart-L mailing list >> >> Send postings to: >> OpenHeart-L@lists.hsforum.com >> >> To UNSUBSCRIBE, to CHANGE email address, or to view archives: >> http://mmp.cjp.com/mailman/listinfo/openheart-l >> >> All messages transmitted by the OpenHeart-L are subject to the >> policies and >> disclaimers posted at: >> http://www.hsforum.com/listdisclaim >> ----------------------------------------- > > Giulio Rizzoli MD FETCS > Cardiochirurgia Padova > tel. 049 821-2408 > fax 049 821-2409 > e-mail giulio.rizzoli@unipd.it > > > _______________________________________________ > OpenHeart-L mailing list > > Send postings to: > OpenHeart-L@lists.hsforum.com > > To UNSUBSCRIBE, to CHANGE email address, or to view archives: > http://mmp.cjp.com/mailman/listinfo/openheart-l > > All messages transmitted by the OpenHeart-L are subject to the > policies and disclaimers posted at: > http://www.hsforum.com/listdisclaim > ----------------------------------------- > > From wftjrtyler at aol.com Wed Nov 1 05:52:30 2006 From: wftjrtyler at aol.com (wftjrtyler@aol.com) Date: Wed Nov 1 05:52:40 2006 Subject: [HSF] Re: Favorite cardiac surgical myths Message-ID: In a message dated 10/31/2006 11:29:13 P.M. Central Standard Time, tacuff@swbell.net writes: BTW...Are not Dr. Cox's categories of afib: intermittent or permanent? intermittent and continuos.....bt From battr at medizin.uni-leipzig.de Wed Nov 1 13:18:35 2006 From: battr at medizin.uni-leipzig.de (Dr. Roberto Battellini) Date: Wed Nov 1 07:14:51 2006 Subject: AW: [HSF] complicationsincardiacsurgery Wiki In-Reply-To: <96CC6A81-BE16-496A-ACDC-6D11F1EDD488@bigpond.com> Message-ID: <20061101121411.7EC066F281@mrzs235220.medizin.uni-leipzig.de> Public domain would be complicate for the cardiac surgeons... Roberto -----Urspr?ngliche Nachricht----- Von: openheart-l-bounces@lists.hsforum.com [mailto:openheart-l-bounces@lists.hsforum.com] Im Auftrag von Donald Ross Gesendet: Mittwoch, 1. November 2006 00:51 An: OpenHeart-L@lists.hsforum.com Betreff: Re: [HSF] complicationsincardiacsurgery Wiki Dear Prasanna, Since the Wiki is in the public domain it will readily become a heavily bookmarked link for the litigation lawyers and perhaps may not be a good idea after all? What do the rest of you think? Don On 31/10/2006, at 1:32 PM, prasannasimha wrote: > Dear All, > I have given a request for the complicationsincardiacsurgery wiki. > The request will probably take 7 days to materialize. > If I get approval, I will give details and we will then be able to > create our Wiki. > I have registered it at Wikia. The original Wiki wiki. > Of created, I would request people to help me out. > All the people who would like to join as a moderator/ monitoring > team , please email me. > Prasanna > _______________________________________________ > OpenHeart-L mailing list > > Send postings to: > OpenHeart-L@lists.hsforum.com > > To UNSUBSCRIBE, to CHANGE email address, or to view archives: > http://mmp.cjp.com/mailman/listinfo/openheart-l > > All messages transmitted by the OpenHeart-L are subject to the > policies and disclaimers posted at: > http://www.hsforum.com/listdisclaim > ----------------------------------------- _______________________________________________ OpenHeart-L mailing list Send postings to: OpenHeart-L@lists.hsforum.com To UNSUBSCRIBE, to CHANGE email address, or to view archives: http://mmp.cjp.com/mailman/listinfo/openheart-l All messages transmitted by the OpenHeart-L are subject to the policies and disclaimers posted at: http://www.hsforum.com/listdisclaim ----------------------------------------- From prasannasimha at gmail.com Wed Nov 1 17:48:48 2006 From: prasannasimha at gmail.com (psimha) Date: Wed Nov 1 07:19:04 2006 Subject: AW: [HSF] complicationsincardiacsurgery Wiki In-Reply-To: <20061101121411.7EC066F281@mrzs235220.medizin.uni-leipzig.de> References: <20061101121411.7EC066F281@mrzs235220.medizin.uni-leipzig.de> Message-ID: <454890A8.5060009@sify.com> Well Roberto , did you think this conversation is private - Type in Google and you can get all our HSF conversations in the past !! So much for private domains !! I have enclosed an email of yours to HSF which I retrieved via Google below !! So now what ? :-) AW: AW: AW: [HSF] inability to find RCA and calcified aorta Dr. Roberto Battellini battr at medizin.uni-leipzig.de Fri May 19 18:14:01 EDT 2006 * Previous message: AW: AW: [HSF] inability to find RCA and calcified aorta * Next message: [HSF] Re: lima inflow for svg * Messages sorted by: [ date ] [ thread ] [ subject ] [ author ] The lady is on the 70?s and with total calcified aorta! Of course, we plan here a lot of double mammaries and radials. In this case, the right mammary had some plaques.If I had knew the diagnostic, I would had done double mammary and radial and looked for a more experienced assistant. The assistant plays a role in BH surgery , or not? I recognize one fault from me: the day before she told she could not read well, suddenly. Clinically she had no neurologic alterations.I asked for a brain CT, which was normal, and forgot to ask for an aorta CT. I should have said like Clinton: One eye problem homolateral is the carotid, both is the aorta, stupid! But she is doing well. Roberto -----Urspr?ngliche Nachricht----- Von: openheart-l-bounces at lists.hsforum.com [mailto:openheart-l-bounces at lists.hsforum.com] Im Auftrag von prasannasimha Gesendet: Freitag, 19. Mai 2006 15:54 An: OpenHeart-L at lists.hsforum.com Betreff: Re: AW: AW: [HSF] inability to find RCA and calcified aorta I still have reservations putting a vein to the LIMA. May be good for now but when vein graft atherosclerosis occurs we will put the LIMA in jeopardy. Prasanna Dr. Roberto Battellini wrote: > Prasanna, > Now I understand, you mind on the beating heart. > Of course, when I do beating heart on the RCA distal, I use shunt. > Today I had scheduled a lady with very diffuse coronary pathology, I planned > with cardioplegia...but...the aorta ascendens and arch were all the calcium > you can imagine. As I had a beginner as assistant, I went on-pump beating > heart putting a very little arterial cannula near the aortic valve as > arterial inflow, the only place without calcification. Then did LIMA to LAD > medial and distal sequential, vein to obtuse marginal and proximal in the > LIMA, and vein to RCA distal (with shunt)and proximal in the RIMA. The whole > RCA and distals were calcified and I put the vein in the only place I could > find without calcium. > We have with other colleagues more or less 47 cases of porcelain or > supercalcified aorta ascendens where we changed the tactic and did beating > heart with pump and non touch the aorta. Sometimes the proximals in the left > carotid or truncus braquiocefalicus in the first cases when I was afraid to > put a vein in the mammary. > Have a good week end, tomorrow I am on duty, let?s see what comes. > Roberto > > -----Urspr?ngliche Nachricht----- > Von: openheart-l-bounces at lists.hsforum.com > [mailto:openheart-l-bounces at lists.hsforum.com] Im Auftrag von prasannasimha > Gesendet: Donnerstag, 18. Mai 2006 17:34 > An: OpenHeart-L at lists.hsforum.com > Betreff: Re: AW: [HSF] inability to find RCA > > Proximal occlusion of the RCA /steal of blood from an open arteriotomy > if a shunt is not placed causes acute marginal steal, RV dysfunction > causing distention and AV nodal Ischemia causes bradycardia and further > distention. > Prasanna > Dr. Roberto Battellini wrote: > >> Why distention of the RV? >> Roberto >> >> -----Urspr?ngliche Nachricht----- >> Von: openheart-l-bounces at lists.hsforum.com >> [mailto:openheart-l-bounces at lists.hsforum.com] Im Auftrag von Salerno, >> > Tomas > >> Gesendet: Donnerstag, 18. Mai 2006 14:53 >> An: OpenHeart-L at lists.hsforum.com >> Betreff: RE: [HSF] inability to find RCA >> >> Always bypass the PDA as it is usually disease free, and one does not >> get heart blocks and other problems including distention of RV when >> bypassing the PDA compared to RCA. >> >> Tomas >> >> -----Original Message----- >> From: openheart-l-bounces at lists.hsforum.com >> [mailto:openheart-l-bounces at lists.hsforum.com] On Behalf Of psimha >> Sent: Thursday, May 18, 2006 8:59 AM >> To: OpenHeart-L at lists.hsforum.com >> Subject: Re: [HSF] inability to find RCA >> >> Why graft the RCA when the PDA is available and graftable.Crux disease >> will limit the patency of the graft if put to the main RCA. >> Prasanna >> john pj wrote: >> >> >>> We had a CABG recently in which we could not find RCA in the AV >>> >>> >> groove. We divided veins and exposed RA and RV walls. We Manged by >> grafting to PDA. >> >> >>> >>> Any body has similar experiences? any ideas? >>> >>> >>> JOHN >>> >>> >>> --------------------------------- >>> How low will we go? Check out Yahoo! Messenger's low PC-to-Phone call >>> >>> >> rates. >> >> >>> _______________________________________________ >>> OpenHeart-L mailing list >>> >>> Send postings to: >>> OpenHeart-L at lists.hsforum.com >>> >>> To unsubscribe, change email address, or view archives: >>> http://mmp.cjp.com/mailman/listinfo/openheart-l >>> >>> All messages transmitted by the OpenHeart-L are subject to the >>> >>> >> policies and >> >> >>> disclaimers posted at: >>> http://www.hsforum.com/listdisclaim >>> ----------------------------------------- >>> >>> >>> >>> >>> >> _______________________________________________ >> OpenHeart-L mailing list >> >> Send postings to: >> OpenHeart-L at lists.hsforum.com >> >> To unsubscribe, change email address, or view archives: >> http://mmp.cjp.com/mailman/listinfo/openheart-l >> >> All messages transmitted by the OpenHeart-L are subject to the policies >> and >> disclaimers posted at: >> http://www.hsforum.com/listdisclaim >> ----------------------------------------- >> _______________________________________________ >> OpenHeart-L mailing list >> >> Send postings to: >> OpenHeart-L at lists.hsforum.com >> >> To unsubscribe, change email address, or view archives: >> http://mmp.cjp.com/mailman/listinfo/openheart-l >> >> All messages transmitted by the OpenHeart-L are subject to the policies >> > and > >> disclaimers posted at: >> http://www.hsforum.com/listdisclaim >> ----------------------------------------- >> >> _______________________________________________ >> OpenHeart-L mailing list >> >> Send postings to: >> OpenHeart-L at lists.hsforum.com >> >> To unsubscribe, change email address, or view archives: >> http://mmp.cjp.com/mailman/listinfo/openheart-l >> >> All messages transmitted by the OpenHeart-L are subject to the policies >> > and > >> disclaimers posted at: >> http://www.hsforum.com/listdisclaim >> ----------------------------------------- >> >> >> >> > > _______________________________________________ > OpenHeart-L mailing list > > Send postings to: > OpenHeart-L at lists.hsforum.com > > To unsubscribe, change email address, or view archives: > http://mmp.cjp.com/mailman/listinfo/openheart-l > > All messages transmitted by the OpenHeart-L are subject to the policies and > disclaimers posted at: > http://www.hsforum.com/listdisclaim > ----------------------------------------- > > _______________________________________________ > OpenHeart-L mailing list > > Send postings to: > OpenHeart-L at lists.hsforum.com > > To unsubscribe, change email address, or view archives: > http://mmp.cjp.com/mailman/listinfo/openheart-l > > All messages transmitted by the OpenHeart-L are subject to the policies and > disclaimers posted at: > http://www.hsforum.com/listdisclaim > ----------------------------------------- > > > _______________________________________________ OpenHeart-L mailing list Send postings to: OpenHeart-L at lists.hsforum.com To unsubscribe, change email address, or view archives: http://mmp.cjp.com/mailman/listinfo/openheart-l All messages transmitted by the OpenHeart-L are subject to the policies and disclaimers posted at: http://www.hsforum.com/listdisclaim ----------------------------------------- * Previous message: AW: AW: [HSF] inability to find RCA and calcified aorta * Next message: [HSF] Re: lima inflow for svg * Messages sorted by: [ date ] [ thread ] [ subject ] [ author ] More information about the OpenHeart-L mailing list Dr. Roberto Battellini wrote: > Public domain would be complicate for the cardiac surgeons... > Roberto > > -----Urspr?ngliche Nachricht----- > Von: openheart-l-bounces@lists.hsforum.com > [mailto:openheart-l-bounces@lists.hsforum.com] Im Auftrag von Donald Ross > Gesendet: Mittwoch, 1. November 2006 00:51 > An: OpenHeart-L@lists.hsforum.com > Betreff: Re: [HSF] complicationsincardiacsurgery Wiki > > Dear Prasanna, > Since the Wiki is in the public domain it will readily become a > heavily bookmarked link for the litigation lawyers and perhaps may > not be a good idea after all? > What do the rest of you think? > Don > > On 31/10/2006, at 1:32 PM, prasannasimha wrote: > > >> Dear All, >> I have given a request for the complicationsincardiacsurgery wiki. >> The request will probably take 7 days to materialize. >> If I get approval, I will give details and we will then be able to >> create our Wiki. >> I have registered it at Wikia. The original Wiki wiki. >> Of created, I would request people to help me out. >> All the people who would like to join as a moderator/ monitoring >> team , please email me. >> Prasanna >> _______________________________________________ >> OpenHeart-L mailing list >> >> Send postings to: >> OpenHeart-L@lists.hsforum.com >> >> To UNSUBSCRIBE, to CHANGE email address, or to view archives: >> http://mmp.cjp.com/mailman/listinfo/openheart-l >> >> All messages transmitted by the OpenHeart-L are subject to the >> policies and disclaimers posted at: >> http://www.hsforum.com/listdisclaim >> ----------------------------------------- >> > _______________________________________________ > OpenHeart-L mailing list > > Send postings to: > OpenHeart-L@lists.hsforum.com > > To UNSUBSCRIBE, to CHANGE email address, or to view archives: > http://mmp.cjp.com/mailman/listinfo/openheart-l > > All messages transmitted by the OpenHeart-L are subject to the policies and > disclaimers posted at: > http://www.hsforum.com/listdisclaim > ----------------------------------------- > > _______________________________________________ > OpenHeart-L mailing list > > Send postings to: > OpenHeart-L@lists.hsforum.com > > To UNSUBSCRIBE, to CHANGE email address, or to view archives: > http://mmp.cjp.com/mailman/listinfo/openheart-l > > All messages transmitted by the OpenHeart-L are subject to the policies and > disclaimers posted at: > http://www.hsforum.com/listdisclaim > ----------------------------------------- > > > From battr at medizin.uni-leipzig.de Wed Nov 1 13:45:02 2006 From: battr at medizin.uni-leipzig.de (Dr. Roberto Battellini) Date: Wed Nov 1 07:40:50 2006 Subject: =?iso-8859-1?Q?AW:_AW:_AW:_=5BHSF=5D_It=B4s_the_cord=2C_...Clinton_says?= =?iso-8859-1?Q?_=28OT=29?= In-Reply-To: <454865EC.8050509@gmail.com> Message-ID: <20061101124037.C75916F262@mrzs235220.medizin.uni-leipzig.de> Prasanna, when he was reelected he said people wants money, didn?t care of Miss XX "It?s the pocket, stupid" (1998 may be) -----Urspr?ngliche Nachricht----- Von: openheart-l-bounces@lists.hsforum.com [mailto:openheart-l-bounces@lists.hsforum.com] Im Auftrag von prasannasimha Gesendet: Mittwoch, 1. November 2006 10:16 An: OpenHeart-L@lists.hsforum.com Betreff: Re: AW: AW: [HSF] It?s the cord, ...Clinton says Yes, what I was saying was for the brain though I do not think the cord is very resistant to true Ischemia (Clamping the cord involves some collateral flow . Regarding Kidneys and Liver , they cannot be better than the time for transplantation. Unfortunately we do not flush perfuse these organs and isolate them so the times will be less. I have used whole body retroperfusion just to keep these organs cool and I do not think they really provide nutritive flow due to valves in the lower body venous circuit. Incidentally I missed out the Clinton bit can somebody explain it to me ? Prasanna Giulio Rizzoli wrote: > The concern about the chord is right, because paraplegia is the most > dreadfull complication for any patient, nonetheless I have always been > teaced that 30' are pretty safe if you repair an isthmic transection > with the Cooley "clamp and go" technique (in the nomogram reported by > Kirklin's book 2?nd edition, on page 1710 the probability is about 10%). > Nonetheless this data are for normothermia! > If You runa perfusion at 28? prior to circulatory arrest you should > have the added protection of some cooling. > Furthermore if the origin of the subclavian artery is snared, while > perfusing both carotid arteries at 28? , there must be perfusion of > the chord by the subclavian collateral circulation through vertebrals, > mammary, intercostal arteries, aso. > The numbers you report are the extimated safe protection of the brain > during circulatory arrest ! > I was wondering if there are in the litterature estimates of the safe > time of circulatory arrest in the lower body (Kidney liver and chord) > while running selective cerebral perfusion with the Kazui technique. > In my "unfortunately too small" experience it was safe up to 35', > plenty of time to carefully prepare an open aortic arch anastomosis. > Giulio Rizzoli > > > >> What I tried to say was that, Prasanna, the cord, that ist he question . >> Hamlet >> -----Urspr?ngliche Nachricht----- >> Von: openheart-l-bounces@lists.hsforum.com >> [mailto:openheart-l-bounces@lists.hsforum.com] Im Auftrag von >> prasannasimha >> Gesendet: Dienstag, 31. Oktober 2006 13:47 >> An: OpenHeart-L@lists.hsforum.com >> Betreff: Re: AW: [HSF] porcellan aorta >> >> My main concern with this trend to "normothermic" brain surgery is that >> we are not protecting the cord. This can lead to unacceptable paraplegia >> if lower body perfusion is interrupted. This may not be so much of a >> concern if lower body perfusion is maintained. >> TCA at 18 deg - 45 min >> TCA at 28 Deg 15 min >> TCA at 32 Deg - 7 min are probably estimates of TCA with negligible >> complications. Beyond this there will be a progressive increase in >> complications. >> >> Prasanna >> >> Dr. Roberto Battellini wrote: >> > No, no data. I confess I am still very conservative, remember the >> people >> of >> > Mount Sinai doing it at 18 grades! Remember the book of Edmunds in >> ctesnet. >> > So for me, 20 Degrees Oesophagus was courageous.But the patient is >> now at >> > normal station!. >> > >> > You opened a very nice question for the HSF, let?s do together. >> > At which oesophagus-rectal, etc temperature do the members make total >> > circulatory arrest without any complication!!!(including >> paraplegia) , and >> > how long is it sure. >> > >> > Roberto >> > >> > >> > -----Urspr?ngliche Nachricht----- >> > Von: openheart-l-bounces@lists.hsforum.com >> > [mailto:openheart-l-bounces@lists.hsforum.com] Im Auftrag von Giulio >> Rizzoli >> > Gesendet: Montag, 30. Oktober 2006 09:11 >> > An: OpenHeart-L@lists.hsforum.com >> > Betreff: Re: [HSF] porcellan aorta >> > >> > Beautiful picture ! Why 20? temperature ? >> > At 27? you can arrest the brain circulation >> > safely for 10 m'. Plenty of time to cannulate the >> > left carotid artery , occlude the left subclavian >> > e completely rperfuse the brain. >> > I think the question is : How long will normal >> > kidney and liver tolerate ischemia at 27? ? Do You have data on it? >> > Giulio Rizzoli >> > >> > >> > >> > >> >> We cannulated the axillary artery and went to 20 degrees >> oesophagus. . >> >> Roberto and Giuseppe, Leipzig >> >> >> >> >> ------------------------------------------------------------------------ >> >> Las mejores tiendas, los precios mas bajos, >> >> entregas en todo el mundo, YupiMSN Compras: Haz >> >> clic aqu?... >> >> >> >> >> >> >> >> _______________________________________________ >> >> OpenHeart-L mailing list >> >> >> >> Send postings to: >> >> OpenHeart-L@lists.hsforum.com >> >> >> >> To UNSUBSCRIBE, to CHANGE email address, or to view archives: >> >> http://mmp.cjp.com/mailman/listinfo/openheart-l >> >> >> >> All messages transmitted by the OpenHeart-L are subject to the >> policies >> and >> >> disclaimers posted at: >> >> http://www.hsforum.com/listdisclaim >> >> ----------------------------------------- >> >> >> > >> > Giulio Rizzoli MD FETCS >> > Cardiochirurgia Padova >> > tel. 049 821-2408 >> > fax 049 821-2409 >> > e-mail giulio.rizzoli@unipd.it >> > >> > >> > _______________________________________________ >> > OpenHeart-L mailing list >> > >> > Send postings to: >> > OpenHeart-L@lists.hsforum.com >> > >> > To UNSUBSCRIBE, to CHANGE email address, or to view archives: >> > http://mmp.cjp.com/mailman/listinfo/openheart-l >> > >> > All messages transmitted by the OpenHeart-L are subject to the >> policies >> and >> > disclaimers posted at: >> > http://www.hsforum.com/listdisclaim >> > ----------------------------------------- >> > >> > _______________________________________________ >> > OpenHeart-L mailing list >> > >> > Send postings to: >> > OpenHeart-L@lists.hsforum.com >> > >> > To UNSUBSCRIBE, to CHANGE email address, or to view archives: >> > http://mmp.cjp.com/mailman/listinfo/openheart-l >> > >> > All messages transmitted by the OpenHeart-L are subject to the >> policies >> and >> > disclaimers posted at: >> > http://www.hsforum.com/listdisclaim >> > ----------------------------------------- >> > >> > >> _______________________________________________ >> OpenHeart-L mailing list >> >> Send postings to: >> OpenHeart-L@lists.hsforum.com >> >> To UNSUBSCRIBE, to CHANGE email address, or to view archives: >> http://mmp.cjp.com/mailman/listinfo/openheart-l >> >> All messages transmitted by the OpenHeart-L are subject to the >> policies and >> disclaimers posted at: >> http://www.hsforum.com/listdisclaim >> ----------------------------------------- >> >> _______________________________________________ >> OpenHeart-L mailing list >> >> Send postings to: >> OpenHeart-L@lists.hsforum.com >> >> To UNSUBSCRIBE, to CHANGE email address, or to view archives: >> http://mmp.cjp.com/mailman/listinfo/openheart-l >> >> All messages transmitted by the OpenHeart-L are subject to the >> policies and >> disclaimers posted at: >> http://www.hsforum.com/listdisclaim >> ----------------------------------------- > > Giulio Rizzoli MD FETCS > Cardiochirurgia Padova > tel. 049 821-2408 > fax 049 821-2409 > e-mail giulio.rizzoli@unipd.it > > > _______________________________________________ > OpenHeart-L mailing list > > Send postings to: > OpenHeart-L@lists.hsforum.com > > To UNSUBSCRIBE, to CHANGE email address, or to view archives: > http://mmp.cjp.com/mailman/listinfo/openheart-l > > All messages transmitted by the OpenHeart-L are subject to the > policies and disclaimers posted at: > http://www.hsforum.com/listdisclaim > ----------------------------------------- > > _______________________________________________ OpenHeart-L mailing list Send postings to: OpenHeart-L@lists.hsforum.com To UNSUBSCRIBE, to CHANGE email address, or to view archives: http://mmp.cjp.com/mailman/listinfo/openheart-l All messages transmitted by the OpenHeart-L are subject to the policies and disclaimers posted at: http://www.hsforum.com/listdisclaim ----------------------------------------- From battr at medizin.uni-leipzig.de Wed Nov 1 13:51:54 2006 From: battr at medizin.uni-leipzig.de (Dr. Roberto Battellini) Date: Wed Nov 1 07:47:39 2006 Subject: =?iso-8859-1?Q?AW:_AW:_AW:_=5BHSF=5D_It=B4s_the_cord=2C_?= In-Reply-To: <454865EC.8050509@gmail.com> Message-ID: <20061101124730.7CCAC6B496@mrzs235220.medizin.uni-leipzig.de> My idea is that perfusion of the descending aorta antegradely through a balloon catheter after the left subclavia or retrogradelly through the femoral with the distal arch anastomosis done can perfuse the cord. But, well, we are talking about the cord temperature and time in which one could get a paraplegia operating the arch. I have no data out of more than 15 minutes at 37 you could get a paraplegia. Roberto -----Urspr?ngliche Nachricht----- Von: openheart-l-bounces@lists.hsforum.com [mailto:openheart-l-bounces@lists.hsforum.com] Im Auftrag von prasannasimha Gesendet: Mittwoch, 1. November 2006 10:16 An: OpenHeart-L@lists.hsforum.com Betreff: Re: AW: AW: [HSF] It?s the cord, ...Clinton says Yes, what I was saying was for the brain though I do not think the cord is very resistant to true Ischemia (Clamping the cord involves some collateral flow . Regarding Kidneys and Liver , they cannot be better than the time for transplantation. Unfortunately we do not flush perfuse these organs and isolate them so the times will be less. I have used whole body retroperfusion just to keep these organs cool and I do not think they really provide nutritive flow due to valves in the lower body venous circuit. Incidentally I missed out the Clinton bit can somebody explain it to me ? Prasanna Giulio Rizzoli wrote: > The concern about the chord is right, because paraplegia is the most > dreadfull complication for any patient, nonetheless I have always been > teaced that 30' are pretty safe if you repair an isthmic transection > with the Cooley "clamp and go" technique (in the nomogram reported by > Kirklin's book 2?nd edition, on page 1710 the probability is about 10%). > Nonetheless this data are for normothermia! > If You runa perfusion at 28? prior to circulatory arrest you should > have the added protection of some cooling. > Furthermore if the origin of the subclavian artery is snared, while > perfusing both carotid arteries at 28? , there must be perfusion of > the chord by the subclavian collateral circulation through vertebrals, > mammary, intercostal arteries, aso. > The numbers you report are the extimated safe protection of the brain > during circulatory arrest ! > I was wondering if there are in the litterature estimates of the safe > time of circulatory arrest in the lower body (Kidney liver and chord) > while running selective cerebral perfusion with the Kazui technique. > In my "unfortunately too small" experience it was safe up to 35', > plenty of time to carefully prepare an open aortic arch anastomosis. > Giulio Rizzoli > > > >> What I tried to say was that, Prasanna, the cord, that ist he question . >> Hamlet >> -----Urspr?ngliche Nachricht----- >> Von: openheart-l-bounces@lists.hsforum.com >> [mailto:openheart-l-bounces@lists.hsforum.com] Im Auftrag von >> prasannasimha >> Gesendet: Dienstag, 31. Oktober 2006 13:47 >> An: OpenHeart-L@lists.hsforum.com >> Betreff: Re: AW: [HSF] porcellan aorta >> >> My main concern with this trend to "normothermic" brain surgery is that >> we are not protecting the cord. This can lead to unacceptable paraplegia >> if lower body perfusion is interrupted. This may not be so much of a >> concern if lower body perfusion is maintained. >> TCA at 18 deg - 45 min >> TCA at 28 Deg 15 min >> TCA at 32 Deg - 7 min are probably estimates of TCA with negligible >> complications. Beyond this there will be a progressive increase in >> complications. >> >> Prasanna >> >> Dr. Roberto Battellini wrote: >> > No, no data. I confess I am still very conservative, remember the >> people >> of >> > Mount Sinai doing it at 18 grades! Remember the book of Edmunds in >> ctesnet. >> > So for me, 20 Degrees Oesophagus was courageous.But the patient is >> now at >> > normal station!. >> > >> > You opened a very nice question for the HSF, let?s do together. >> > At which oesophagus-rectal, etc temperature do the members make total >> > circulatory arrest without any complication!!!(including >> paraplegia) , and >> > how long is it sure. >> > >> > Roberto >> > >> > >> > -----Urspr?ngliche Nachricht----- >> > Von: openheart-l-bounces@lists.hsforum.com >> > [mailto:openheart-l-bounces@lists.hsforum.com] Im Auftrag von Giulio >> Rizzoli >> > Gesendet: Montag, 30. Oktober 2006 09:11 >> > An: OpenHeart-L@lists.hsforum.com >> > Betreff: Re: [HSF] porcellan aorta >> > >> > Beautiful picture ! Why 20? temperature ? >> > At 27? you can arrest the brain circulation >> > safely for 10 m'. Plenty of time to cannulate the >> > left carotid artery , occlude the left subclavian >> > e completely rperfuse the brain. >> > I think the question is : How long will normal >> > kidney and liver tolerate ischemia at 27? ? Do You have data on it? >> > Giulio Rizzoli >> > >> > >> > >> > >> >> We cannulated the axillary artery and went to 20 degrees >> oesophagus. . >> >> Roberto and Giuseppe, Leipzig >> >> >> >> >> ------------------------------------------------------------------------ >> >> Las mejores tiendas, los precios mas bajos, >> >> entregas en todo el mundo, YupiMSN Compras: Haz >> >> clic aqu?... >> >> >> >> >> >> >> >> _______________________________________________ >> >> OpenHeart-L mailing list >> >> >> >> Send postings to: >> >> OpenHeart-L@lists.hsforum.com >> >> >> >> To UNSUBSCRIBE, to CHANGE email address, or to view archives: >> >> http://mmp.cjp.com/mailman/listinfo/openheart-l >> >> >> >> All messages transmitted by the OpenHeart-L are subject to the >> policies >> and >> >> disclaimers posted at: >> >> http://www.hsforum.com/listdisclaim >> >> ----------------------------------------- >> >> >> > >> > Giulio Rizzoli MD FETCS >> > Cardiochirurgia Padova >> > tel. 049 821-2408 >> > fax 049 821-2409 >> > e-mail giulio.rizzoli@unipd.it >> > >> > >> > _______________________________________________ >> > OpenHeart-L mailing list >> > >> > Send postings to: >> > OpenHeart-L@lists.hsforum.com >> > >> > To UNSUBSCRIBE, to CHANGE email address, or to view archives: >> > http://mmp.cjp.com/mailman/listinfo/openheart-l >> > >> > All messages transmitted by the OpenHeart-L are subject to the >> policies >> and >> > disclaimers posted at: >> > http://www.hsforum.com/listdisclaim >> > ----------------------------------------- >> > >> > _______________________________________________ >> > OpenHeart-L mailing list >> > >> > Send postings to: >> > OpenHeart-L@lists.hsforum.com >> > >> > To UNSUBSCRIBE, to CHANGE email address, or to view archives: >> > http://mmp.cjp.com/mailman/listinfo/openheart-l >> > >> > All messages transmitted by the OpenHeart-L are subject to the >> policies >> and >> > disclaimers posted at: >> > http://www.hsforum.com/listdisclaim >> > ----------------------------------------- >> > >> > >> _______________________________________________ >> OpenHeart-L mailing list >> >> Send postings to: >> OpenHeart-L@lists.hsforum.com >> >> To UNSUBSCRIBE, to CHANGE email address, or to view archives: >> http://mmp.cjp.com/mailman/listinfo/openheart-l >> >> All messages transmitted by the OpenHeart-L are subject to the >> policies and >> disclaimers posted at: >> http://www.hsforum.com/listdisclaim >> ----------------------------------------- >> >> _______________________________________________ >> OpenHeart-L mailing list >> >> Send postings to: >> OpenHeart-L@lists.hsforum.com >> >> To UNSUBSCRIBE, to CHANGE email address, or to view archives: >> http://mmp.cjp.com/mailman/listinfo/openheart-l >> >> All messages transmitted by the OpenHeart-L are subject to the >> policies and >> disclaimers posted at: >> http://www.hsforum.com/listdisclaim >> ----------------------------------------- > > Giulio Rizzoli MD FETCS > Cardiochirurgia Padova > tel. 049 821-2408 > fax 049 821-2409 > e-mail giulio.rizzoli@unipd.it > > > _______________________________________________ > OpenHeart-L mailing list > > Send postings to: > OpenHeart-L@lists.hsforum.com > > To UNSUBSCRIBE, to CHANGE email address, or to view archives: > http://mmp.cjp.com/mailman/listinfo/openheart-l > > All messages transmitted by the OpenHeart-L are subject to the > policies and disclaimers posted at: > http://www.hsforum.com/listdisclaim > ----------------------------------------- > > _______________________________________________ OpenHeart-L mailing list Send postings to: OpenHeart-L@lists.hsforum.com To UNSUBSCRIBE, to CHANGE email address, or to view archives: http://mmp.cjp.com/mailman/listinfo/openheart-l All messages transmitted by the OpenHeart-L are subject to the policies and disclaimers posted at: http://www.hsforum.com/listdisclaim ----------------------------------------- From battr at medizin.uni-leipzig.de Wed Nov 1 13:59:03 2006 From: battr at medizin.uni-leipzig.de (Dr. Roberto Battellini) Date: Wed Nov 1 07:55:19 2006 Subject: AW: AW: [HSF] complicationsincardiacsurgery Wiki In-Reply-To: <454890A8.5060009@sify.com> Message-ID: <20061101125438.C84BF6F25B@mrzs235220.medizin.uni-leipzig.de> OK, Prasanna, you won. Let?s write all in a way that help others . By the way, I see I mentioned Clinton already! Roberto -----Urspr?ngliche Nachricht----- Von: openheart-l-bounces@lists.hsforum.com [mailto:openheart-l-bounces@lists.hsforum.com] Im Auftrag von psimha Gesendet: Mittwoch, 1. November 2006 13:19 An: OpenHeart-L@lists.hsforum.com Betreff: Re: AW: [HSF] complicationsincardiacsurgery Wiki Well Roberto , did you think this conversation is private - Type in Google and you can get all our HSF conversations in the past !! So much for private domains !! I have enclosed an email of yours to HSF which I retrieved via Google below !! So now what ? :-) AW: AW: AW: [HSF] inability to find RCA and calcified aorta Dr. Roberto Battellini battr at medizin.uni-leipzig.de Fri May 19 18:14:01 EDT 2006 * Previous message: AW: AW: [HSF] inability to find RCA and calcified aorta * Next message: [HSF] Re: lima inflow for svg * Messages sorted by: [ date ] [ thread ] [ subject ] [ author ] The lady is on the 70?s and with total calcified aorta! Of course, we plan here a lot of double mammaries and radials. In this case, the right mammary had some plaques.If I had knew the diagnostic, I would had done double mammary and radial and looked for a more experienced assistant. The assistant plays a role in BH surgery , or not? I recognize one fault from me: the day before she told she could not read well, suddenly. Clinically she had no neurologic alterations.I asked for a brain CT, which was normal, and forgot to ask for an aorta CT. I should have said like Clinton: One eye problem homolateral is the carotid, both is the aorta, stupid! But she is doing well. Roberto -----Urspr?ngliche Nachricht----- Von: openheart-l-bounces at lists.hsforum.com [mailto:openheart-l-bounces at lists.hsforum.com] Im Auftrag von prasannasimha Gesendet: Freitag, 19. Mai 2006 15:54 An: OpenHeart-L at lists.hsforum.com Betreff: Re: AW: AW: [HSF] inability to find RCA and calcified aorta I still have reservations putting a vein to the LIMA. May be good for now but when vein graft atherosclerosis occurs we will put the LIMA in jeopardy. Prasanna Dr. Roberto Battellini wrote: > Prasanna, > Now I understand, you mind on the beating heart. > Of course, when I do beating heart on the RCA distal, I use shunt. > Today I had scheduled a lady with very diffuse coronary pathology, I planned > with cardioplegia...but...the aorta ascendens and arch were all the calcium > you can imagine. As I had a beginner as assistant, I went on-pump beating > heart putting a very little arterial cannula near the aortic valve as > arterial inflow, the only place without calcification. Then did LIMA to LAD > medial and distal sequential, vein to obtuse marginal and proximal in the > LIMA, and vein to RCA distal (with shunt)and proximal in the RIMA. The whole > RCA and distals were calcified and I put the vein in the only place I could > find without calcium. > We have with other colleagues more or less 47 cases of porcelain or > supercalcified aorta ascendens where we changed the tactic and did beating > heart with pump and non touch the aorta. Sometimes the proximals in the left > carotid or truncus braquiocefalicus in the first cases when I was afraid to > put a vein in the mammary. > Have a good week end, tomorrow I am on duty, let?s see what comes. > Roberto > > -----Urspr?ngliche Nachricht----- > Von: openheart-l-bounces at lists.hsforum.com > [mailto:openheart-l-bounces at lists.hsforum.com] Im Auftrag von prasannasimha > Gesendet: Donnerstag, 18. Mai 2006 17:34 > An: OpenHeart-L at lists.hsforum.com > Betreff: Re: AW: [HSF] inability to find RCA > > Proximal occlusion of the RCA /steal of blood from an open arteriotomy > if a shunt is not placed causes acute marginal steal, RV dysfunction > causing distention and AV nodal Ischemia causes bradycardia and further > distention. > Prasanna > Dr. Roberto Battellini wrote: > >> Why distention of the RV? >> Roberto >> >> -----Urspr?ngliche Nachricht----- >> Von: openheart-l-bounces at lists.hsforum.com >> [mailto:openheart-l-bounces at lists.hsforum.com] Im Auftrag von Salerno, >> > Tomas > >> Gesendet: Donnerstag, 18. Mai 2006 14:53 >> An: OpenHeart-L at lists.hsforum.com >> Betreff: RE: [HSF] inability to find RCA >> >> Always bypass the PDA as it is usually disease free, and one does not >> get heart blocks and other problems including distention of RV when >> bypassing the PDA compared to RCA. >> >> Tomas >> >> -----Original Message----- >> From: openheart-l-bounces at lists.hsforum.com >> [mailto:openheart-l-bounces at lists.hsforum.com] On Behalf Of psimha >> Sent: Thursday, May 18, 2006 8:59 AM >> To: OpenHeart-L at lists.hsforum.com >> Subject: Re: [HSF] inability to find RCA >> >> Why graft the RCA when the PDA is available and graftable.Crux disease >> will limit the patency of the graft if put to the main RCA. >> Prasanna >> john pj wrote: >> >> >>> We had a CABG recently in which we could not find RCA in the AV >>> >>> >> groove. We divided veins and exposed RA and RV walls. We Manged by >> grafting to PDA. >> >> >>> >>> Any body has similar experiences? any ideas? >>> >>> >>> JOHN >>> >>> >>> --------------------------------- >>> How low will we go? Check out Yahoo! Messenger's low PC-to-Phone call >>> >>> >> rates. >> >> >>> _______________________________________________ >>> OpenHeart-L mailing list >>> >>> Send postings to: >>> OpenHeart-L at lists.hsforum.com >>> >>> To unsubscribe, change email address, or view archives: >>> http://mmp.cjp.com/mailman/listinfo/openheart-l >>> >>> All messages transmitted by the OpenHeart-L are subject to the >>> >>> >> policies and >> >> >>> disclaimers posted at: >>> http://www.hsforum.com/listdisclaim >>> ----------------------------------------- >>> >>> >>> >>> >>> >> _______________________________________________ >> OpenHeart-L mailing list >> >> Send postings to: >> OpenHeart-L at lists.hsforum.com >> >> To unsubscribe, change email address, or view archives: >> http://mmp.cjp.com/mailman/listinfo/openheart-l >> >> All messages transmitted by the OpenHeart-L are subject to the policies >> and >> disclaimers posted at: >> http://www.hsforum.com/listdisclaim >> ----------------------------------------- >> _______________________________________________ >> OpenHeart-L mailing list >> >> Send postings to: >> OpenHeart-L at lists.hsforum.com >> >> To unsubscribe, change email address, or view archives: >> http://mmp.cjp.com/mailman/listinfo/openheart-l >> >> All messages transmitted by the OpenHeart-L are subject to the policies >> > and > >> disclaimers posted at: >> http://www.hsforum.com/listdisclaim >> ----------------------------------------- >> >> _______________________________________________ >> OpenHeart-L mailing list >> >> Send postings to: >> OpenHeart-L at lists.hsforum.com >> >> To unsubscribe, change email address, or view archives: >> http://mmp.cjp.com/mailman/listinfo/openheart-l >> >> All messages transmitted by the OpenHeart-L are subject to the policies >> > and > >> disclaimers posted at: >> http://www.hsforum.com/listdisclaim >> ----------------------------------------- >> >> >> >> > > _______________________________________________ > OpenHeart-L mailing list > > Send postings to: > OpenHeart-L at lists.hsforum.com > > To unsubscribe, change email address, or view archives: > http://mmp.cjp.com/mailman/listinfo/openheart-l > > All messages transmitted by the OpenHeart-L are subject to the policies and > disclaimers posted at: > http://www.hsforum.com/listdisclaim > ----------------------------------------- > > _______________________________________________ > OpenHeart-L mailing list > > Send postings to: > OpenHeart-L at lists.hsforum.com > > To unsubscribe, change email address, or view archives: > http://mmp.cjp.com/mailman/listinfo/openheart-l > > All messages transmitted by the OpenHeart-L are subject to the policies and > disclaimers posted at: > http://www.hsforum.com/listdisclaim > ----------------------------------------- > > > _______________________________________________ OpenHeart-L mailing list Send postings to: OpenHeart-L at lists.hsforum.com To unsubscribe, change email address, or view archives: http://mmp.cjp.com/mailman/listinfo/openheart-l All messages transmitted by the OpenHeart-L are subject to the policies and disclaimers posted at: http://www.hsforum.com/listdisclaim ----------------------------------------- * Previous message: AW: AW: [HSF] inability to find RCA and calcified aorta * Next message: [HSF] Re: lima inflow for svg * Messages sorted by: [ date ] [ thread ] [ subject ] [ author ] More information about the OpenHeart-L mailing list Dr. Roberto Battellini wrote: > Public domain would be complicate for the cardiac surgeons... > Roberto > > -----Urspr?ngliche Nachricht----- > Von: openheart-l-bounces@lists.hsforum.com > [mailto:openheart-l-bounces@lists.hsforum.com] Im Auftrag von Donald Ross > Gesendet: Mittwoch, 1. November 2006 00:51 > An: OpenHeart-L@lists.hsforum.com > Betreff: Re: [HSF] complicationsincardiacsurgery Wiki > > Dear Prasanna, > Since the Wiki is in the public domain it will readily become a > heavily bookmarked link for the litigation lawyers and perhaps may > not be a good idea after all? > What do the rest of you think? > Don > > On 31/10/2006, at 1:32 PM, prasannasimha wrote: > > >> Dear All, >> I have given a request for the complicationsincardiacsurgery wiki. >> The request will probably take 7 days to materialize. >> If I get approval, I will give details and we will then be able to >> create our Wiki. >> I have registered it at Wikia. The original Wiki wiki. >> Of created, I would request people to help me out. >> All the people who would like to join as a moderator/ monitoring >> team , please email me. >> Prasanna >> _______________________________________________ >> OpenHeart-L mailing list >> >> Send postings to: >> OpenHeart-L@lists.hsforum.com >> >> To UNSUBSCRIBE, to CHANGE email address, or to view archives: >> http://mmp.cjp.com/mailman/listinfo/openheart-l >> >> All messages transmitted by the OpenHeart-L are subject to the >> policies and disclaimers posted at: >> http://www.hsforum.com/listdisclaim >> ----------------------------------------- >> > _______________________________________________ > OpenHeart-L mailing list > > Send postings to: > OpenHeart-L@lists.hsforum.com > > To UNSUBSCRIBE, to CHANGE email address, or to view archives: > http://mmp.cjp.com/mailman/listinfo/openheart-l > > All messages transmitted by the OpenHeart-L are subject to the policies and > disclaimers posted at: > http://www.hsforum.com/listdisclaim > ----------------------------------------- > > _______________________________________________ > OpenHeart-L mailing list > > Send postings to: > OpenHeart-L@lists.hsforum.com > > To UNSUBSCRIBE, to CHANGE email address, or to view archives: > http://mmp.cjp.com/mailman/listinfo/openheart-l > > All messages transmitted by the OpenHeart-L are subject to the policies and > disclaimers posted at: > http://www.hsforum.com/listdisclaim > ----------------------------------------- > > > _______________________________________________ OpenHeart-L mailing list Send postings to: OpenHeart-L@lists.hsforum.com To UNSUBSCRIBE, to CHANGE email address, or to view archives: http://mmp.cjp.com/mailman/listinfo/openheart-l All messages transmitted by the OpenHeart-L are subject to the policies and disclaimers posted at: http://www.hsforum.com/listdisclaim ----------------------------------------- From nfaabouseada at gmail.com Wed Nov 1 08:00:14 2006 From: nfaabouseada at gmail.com (Nasser F. Abou'Seada) Date: Wed Nov 1 08:00:29 2006 Subject: [HSF] complicationsincardiacsurgery Wiki In-Reply-To: <45483923.9080302@sify.com> Message-ID: <001901c6fdb5$ae278010$0801a8c0@OEM> Dear Prasanna I do agree with your concept ... not against it at all .... please revise my email ... first one to ask to count me in ...... also I do agree with your concepts about free flow of / and free access to information -vs knowledge- I totally disagree -albeit in vain ... of no value- to restricted access to scientific journals .... should the medical community be really looking for advancement and progress ... vs merchandising and experimenting on the expense of the weaker sides of humanity as a community ..... nevertheless .... this is NOT the issue I'm discussing or that I meant ...... I meant that one should be very vigilant to minimize all side effects by all and whatever means ..... the first of all is to avoid the Bloody suckers as they have been quoted ........ mind you .... I have no such harassments in my country of the kind .. by virtue of ignorance ....... mind you .... many of my discussions on the forum ... that I had to withstand a harsh style of discussion .... were essentially cause I touched a hidden sore spot ..... mentioning the legitimate responsibility of a surgeon towards a non-standard practice ......... !!!! ... of course you do remember that .... Still .... I do agree with you about the importance of the concurrent human factor / variable .... in substantiating a well documented evidence based practice ...... no doubt about that ..... even in some countries Holy Books, as you have implied "with reservation on quoting the analogy" .... the Human Variable of interpreting the revealed meaning is essential ..... a relation that has been thoroughly discussed and judged .. some 900-1200 years ago .... I'm sure you do recall the Infamous scholar "Ibn Hazm" and philosopher "Ibn Khaldoun" ... Being vigilant .... does not by any means count against the idea ..... meanwhile ....... there is a good idea that I have seen on GE radiology website .... where access to the medical site is restricted exclusively to medical profession ..... the site and the idea look appealing ..... why not give it a thought ........ Faisal Cheema can surely help you with that .... I'm not against the idea ........ by all means ....... au contraire .... I'm having no harm in my part of the world .... as I'm sure you to be the same ......... albeit .... to my mind ... I think one should be careful with touching sore points -Tomas Salerno gave me the first advise that Hal later explained to me .... about the use of TEXT BOOKS .... .. first time that I've joined HSF- as I said ......the efforts required are tremendous ..... yet the goal is a great one as well .... with whatever means of vigilance, protection and responsible indemnity notes ...!!!!!! ..... I'd be very grateful if to be of any help ...... NFA > -----Original Message----- > From: openheart-l-bounces@lists.hsforum.com [mailto:openheart-l- > bounces@lists.hsforum.com] On Behalf Of psimha > Sent: Wednesday, November 01, 2006 1:05 AM > To: OpenHeart-L@lists.hsforum.com > Subject: Re: [HSF] complicationsincardiacsurgery Wiki > > Nasser - knowledge flow cannot be suppressed - it can be accessed by > those who are interested and also determined to get it !! > The wiki format will allow interested people to easily access it. As I > said there will be appropriate disclaimers and references to it in > every page. > here are whole text books to feed the lawyers grist but remember no > textbook or document can be admitted without a human collaboration in > the evidence act except probably in some countries holy books but even > these have to be quoted and concurred by a human interpreter. Remember > that the Internet precisely has benefited humanity by its "open > access". There will always be people misusing it as is everything else > in life. > At present Dr Bidstrup and Faisal Cheema have agreed to help in > moderators. Don has too agree to the idea. > I hope I get the approval from Wikia and if it goes through we can start. > Proably we can start with > step 1 Patient preparation > step 2 Induction of the patient > Step 3 Cannulation for CPB > Prasanna > Nasser F. Abou'Seada wrote: > > I concur with Don ... is there a way to make it a private domain ? .. not > > necessarily a wiki one ..! > > > > > > NFA > > > > > >> From: Donald Ross > >> Dear Prasanna, > >> Since the Wiki is in the public domain it will readily become a > >> heavily bookmarked link for the litigation lawyers and perhaps may > >> not be a good idea after all? > >> What do the rest of you think? > >> Don > >> > >> On 31/10/2006, at 1:32 PM, prasannasimha wrote: > >> > >> > >>> Dear All, > >>> I have given a request for the complicationsincardiacsurgery wiki. > >>> The request will probably take 7 days to materialize. > >>> If I get approval, I will give details and we will then be able to > >>> create our Wiki. > >>> I have registered it at Wikia. The original Wiki wiki. > >>> Of created, I would request people to help me out. > >>> All the people who would like to join as a moderator/ monitoring > >>> team , please email me. > >>> Prasanna > >>> _______________________________________________ > >>> OpenHeart-L mailing list > >>> > >>> Send postings to: > >>> OpenHeart-L@lists.hsforum.com > >>> > >>> To UNSUBSCRIBE, to CHANGE email address, or to view archives: > >>> http://mmp.cjp.com/mailman/listinfo/openheart-l > >>> > >>> All messages transmitted by the OpenHeart-L are subject to the > >>> policies and disclaimers posted at: > >>> http://www.hsforum.com/listdisclaim > >>> ----------------------------------------- > >>> > >> _______________________________________________ > >> OpenHeart-L mailing list > >> > >> Send postings to: > >> OpenHeart-L@lists.hsforum.com > >> > >> To UNSUBSCRIBE, to CHANGE email address, or to view archives: > >> http://mmp.cjp.com/mailman/listinfo/openheart-l > >> > >> All messages transmitted by the OpenHeart-L are subject to the policies > >> > > and > > > >> disclaimers posted at: > >> http://www.hsforum.com/listdisclaim > >> ----------------------------------------- > >> > > > > _______________________________________________ > > OpenHeart-L mailing list > > > > Send postings to: > > OpenHeart-L@lists.hsforum.com > > > > To UNSUBSCRIBE, to CHANGE email address, or to view archives: > > http://mmp.cjp.com/mailman/listinfo/openheart-l > > > > All messages transmitted by the OpenHeart-L are subject to the policies and > > disclaimers posted at: > > http://www.hsforum.com/listdisclaim > > ----------------------------------------- > > > > > > > > _______________________________________________ > OpenHeart-L mailing list > > Send postings to: > OpenHeart-L@lists.hsforum.com > > To UNSUBSCRIBE, to CHANGE email address, or to view archives: > http://mmp.cjp.com/mailman/listinfo/openheart-l > > All messages transmitted by the OpenHeart-L are subject to the policies and > disclaimers posted at: > http://www.hsforum.com/listdisclaim > ----------------------------------------- From prasannasimha at gmail.com Wed Nov 1 18:12:12 2006 From: prasannasimha at gmail.com (prasannasimha) Date: Wed Nov 1 10:19:37 2006 Subject: [HSF] Bangalore renamed Message-ID: <45489624.7090704@gmail.com> Bangalore has been renamed Bengaluru (pronounced as Bengalooru today) (50th year of formation of the Karnataka state). Bengalooru was the old and traditional name of Bangalore which was an anglicized version of the original name. The official name change will be done after publication in the Federal Gazette. Prasanna From prasannasimha at gmail.com Wed Nov 1 20:40:33 2006 From: prasannasimha at gmail.com (prasannasimha) Date: Wed Nov 1 11:55:55 2006 Subject: [HSF] Persistant Hyperkalemia Message-ID: <4548B8E9.9020506@gmail.com> Double valve replacement with Tricuspid annuloplasty done 2 days back. Uneventful post op and extubated on 5 mics of dobutamine and dopamine. Started getting hyperkalemia since today 3 AM. No clinical or biochemical evidence of low output/hemolysis. Urine clear.Echo normal - no evidence of paravalvar leak . Lactate 2.7 mmol. Creat 1.5 mg/dL and BUN 43 mg/dL Initially manged hyperkalemia with Lasix , Calcium , glucose Insulin Alkalinizaation K binding resin etc but K went upto 6.8 so started PDtoday mrning. K+ dropped to 5.1 but now despite good extraction on PD , good urine etc last K+ just done now is 6.0. Cannot identify the cause of such persistant hyperkalemia. I have removed all nephrotoxic drugs. No additional K + sources and I have specifically asked K free diet. Any ideas/suggestions. Prasanna From msfirst at gmail.com Wed Nov 1 11:58:04 2006 From: msfirst at gmail.com (Michael Firstenberg) Date: Wed Nov 1 11:58:09 2006 Subject: [HSF] Persistant Hyperkalemia In-Reply-To: <4548B8E9.9020506@gmail.com> References: <4548B8E9.9020506@gmail.com> Message-ID: any pre-op medical problems? Metformin pre-op? michael On 11/1/06, prasannasimha wrote: > > Double valve replacement with Tricuspid annuloplasty done 2 days back. > Uneventful post op and extubated on 5 mics of dobutamine and dopamine. > Started getting hyperkalemia since today 3 AM. No clinical or > biochemical evidence of low output/hemolysis. Urine clear.Echo normal - > no evidence of paravalvar leak . Lactate 2.7 mmol. Creat 1.5 mg/dL and > BUN 43 mg/dL > Initially manged hyperkalemia with Lasix , Calcium , glucose Insulin > Alkalinizaation K binding resin etc but K went upto 6.8 so started > PDtoday mrning. K+ dropped to 5.1 but now despite good extraction on PD > , good urine etc last K+ just done now is 6.0. Cannot identify the cause > of such persistant hyperkalemia. I have removed all nephrotoxic drugs. > No additional K + sources and I have specifically asked K free diet. > Any ideas/suggestions. > Prasanna > > _______________________________________________ > OpenHeart-L mailing list > > Send postings to: > OpenHeart-L@lists.hsforum.com > > To UNSUBSCRIBE, to CHANGE email address, or to view archives: > http://mmp.cjp.com/mailman/listinfo/openheart-l > > All messages transmitted by the OpenHeart-L are subject to the policies > and > disclaimers posted at: > http://www.hsforum.com/listdisclaim > ----------------------------------------- > From prasannasimha at gmail.com Wed Nov 1 22:31:53 2006 From: prasannasimha at gmail.com (prasannasimha) Date: Wed Nov 1 12:02:02 2006 Subject: [HSF] Persistant Hyperkalemia In-Reply-To: References: <4548B8E9.9020506@gmail.com> Message-ID: <4548D301.7000404@gmail.com> No not on Metformin (Not a diabetic) or any Aldosterone inhibitors, NSAID's , Aminoglycosides withdrawn. No known preop problem to cause hyperkalemia. Prasanna Michael Firstenberg wrote: > any pre-op medical problems? > Metformin pre-op? > > > michael > > > On 11/1/06, prasannasimha wrote: >> >> Double valve replacement with Tricuspid annuloplasty done 2 days back. >> Uneventful post op and extubated on 5 mics of dobutamine and dopamine. >> Started getting hyperkalemia since today 3 AM. No clinical or >> biochemical evidence of low output/hemolysis. Urine clear.Echo normal - >> no evidence of paravalvar leak . Lactate 2.7 mmol. Creat 1.5 mg/dL and >> BUN 43 mg/dL >> Initially manged hyperkalemia with Lasix , Calcium , glucose Insulin >> Alkalinizaation K binding resin etc but K went upto 6.8 so started >> PDtoday mrning. K+ dropped to 5.1 but now despite good extraction on PD >> , good urine etc last K+ just done now is 6.0. Cannot identify the cause >> of such persistant hyperkalemia. I have removed all nephrotoxic drugs. >> No additional K + sources and I have specifically asked K free diet. >> Any ideas/suggestions. >> Prasanna >> >> _______________________________________________ >> OpenHeart-L mailing list >> >> Send postings to: >> OpenHeart-L@lists.hsforum.com >> >> To UNSUBSCRIBE, to CHANGE email address, or to view archives: >> http://mmp.cjp.com/mailman/listinfo/openheart-l >> >> All messages transmitted by the OpenHeart-L are subject to the policies >> and >> disclaimers posted at: >> http://www.hsforum.com/listdisclaim >> ----------------------------------------- >> > _______________________________________________ > OpenHeart-L mailing list > > Send postings to: > OpenHeart-L@lists.hsforum.com > > To UNSUBSCRIBE, to CHANGE email address, or to view archives: > http://mmp.cjp.com/mailman/listinfo/openheart-l > > All messages transmitted by the OpenHeart-L are subject to the > policies and disclaimers posted at: > http://www.hsforum.com/listdisclaim > ----------------------------------------- > From msfirst at gmail.com Wed Nov 1 12:04:53 2006 From: msfirst at gmail.com (Michael Firstenberg) Date: Wed Nov 1 12:12:01 2006 Subject: [HSF] Persistant Hyperkalemia In-Reply-To: <4548D301.7000404@gmail.com> References: <4548B8E9.9020506@gmail.com> <4548D301.7000404@gmail.com> Message-ID: an obvious question - even though I know you are a very good doctor (and not just a great surgeon) - no compartment syndrome anywhere? (arm from a-line, legs). The lactate is also concerning? I have seen this a few times, just kinda goes away and never really sure why. michael On 11/1/06, prasannasimha wrote: > > No not on Metformin (Not a diabetic) or any Aldosterone inhibitors, > NSAID's , Aminoglycosides withdrawn. No known preop problem to cause > hyperkalemia. > > Prasanna > > Michael Firstenberg wrote: > > any pre-op medical problems? > > Metformin pre-op? > > > > > > michael > > > > > > On 11/1/06, prasannasimha wrote: > >> > >> Double valve replacement with Tricuspid annuloplasty done 2 days back. > >> Uneventful post op and extubated on 5 mics of dobutamine and dopamine. > >> Started getting hyperkalemia since today 3 AM. No clinical or > >> biochemical evidence of low output/hemolysis. Urine clear.Echo normal - > >> no evidence of paravalvar leak . Lactate 2.7 mmol. Creat 1.5 mg/dL and > >> BUN 43 mg/dL > >> Initially manged hyperkalemia with Lasix , Calcium , glucose Insulin > >> Alkalinizaation K binding resin etc but K went upto 6.8 so started > >> PDtoday mrning. K+ dropped to 5.1 but now despite good extraction on PD > >> , good urine etc last K+ just done now is 6.0. Cannot identify the > cause > >> of such persistant hyperkalemia. I have removed all nephrotoxic drugs. > >> No additional K + sources and I have specifically asked K free diet. > >> Any ideas/suggestions. > >> Prasanna > >> > >> _______________________________________________ > >> OpenHeart-L mailing list > >> > >> Send postings to: > >> OpenHeart-L@lists.hsforum.com > >> > >> To UNSUBSCRIBE, to CHANGE email address, or to view archives: > >> http://mmp.cjp.com/mailman/listinfo/openheart-l > >> > >> All messages transmitted by the OpenHeart-L are subject to the policies > >> and > >> disclaimers posted at: > >> http://www.hsforum.com/listdisclaim > >> ----------------------------------------- > >> > > _______________________________________________ > > OpenHeart-L mailing list > > > > Send postings to: > > OpenHeart-L@lists.hsforum.com > > > > To UNSUBSCRIBE, to CHANGE email address, or to view archives: > > http://mmp.cjp.com/mailman/listinfo/openheart-l > > > > All messages transmitted by the OpenHeart-L are subject to the > > policies and disclaimers posted at: > > http://www.hsforum.com/listdisclaim > > ----------------------------------------- > > > _______________________________________________ > OpenHeart-L mailing list > > Send postings to: > OpenHeart-L@lists.hsforum.com > > To UNSUBSCRIBE, to CHANGE email address, or to view archives: > http://mmp.cjp.com/mailman/listinfo/openheart-l > > All messages transmitted by the OpenHeart-L are subject to the policies > and > disclaimers posted at: > http://www.hsforum.com/listdisclaim > ----------------------------------------- > From rsboova at comcast.net Wed Nov 1 17:18:07 2006 From: rsboova at comcast.net (rsboova@comcast.net) Date: Wed Nov 1 12:18:11 2006 Subject: [HSF] agency for health care and research AHRQ Message-ID: <110120061718.5285.4548D6CF000A3918000014A522007456720E9001010D9C9D@comcast.net> Have converted to nearly 100% OPCAB over past few years . Is less bleeding, less ventilator time , less post op delirium , increasing grafts / patient since earlier years . Otherwise no difference in major outcome parameters i.e. death, CVA , renal fail , LOS , MI etc. Both very satisfactory and comparable to STS benchmarks . OPCAB has been beneficial experience but not always do our individual experiences parallel those reported . RSB -------------- Original message -------------- From: Donald Ross > Here is an interesting release from this mob > http://www.ahrq.gov/news/press/pr2006/offpumppr.htm > _______________________________________________ > OpenHeart-L mailing list > > Send postings to: > OpenHeart-L@lists.hsforum.com > > To UNSUBSCRIBE, to CHANGE email address, or to view archives: > http://mmp.cjp.com/mailman/listinfo/openheart-l > > All messages transmitted by the OpenHeart-L are subject to the policies and > disclaimers posted at: > http://www.hsforum.com/listdisclaim > ----------------------------------------- From prasannasimha at gmail.com Wed Nov 1 22:49:59 2006 From: prasannasimha at gmail.com (psimha) Date: Wed Nov 1 12:20:23 2006 Subject: [HSF] Persistant Hyperkalemia In-Reply-To: References: <4548B8E9.9020506@gmail.com> <4548D301.7000404@gmail.com> Message-ID: <4548D73F.2060704@sify.com> Yes - ruled out compartment syndromes (as a part of hyperkalemia examination) (Very relevant question and worth reiterating) Lactate is normal now. Found out now that Heparin can cause Aldosterone inhibition so stopped that too (in the flushes ) though I do not think that the small doses in the flushes should really matter. Latest K is 5.3 after dialysis (peritoneal) and a GI drip.(Got tired of my resident phoning me a value above 6.0) Prasanna Michael Firstenberg wrote: > an obvious question - even though I know you are a very good doctor > (and not > just a great surgeon) - no compartment syndrome anywhere? (arm from > a-line, > legs). The lactate is also concerning? I have seen this a few times, > just > kinda goes away and never really sure why. > > michael > > > On 11/1/06, prasannasimha wrote: >> >> No not on Metformin (Not a diabetic) or any Aldosterone inhibitors, >> NSAID's , Aminoglycosides withdrawn. No known preop problem to cause >> hyperkalemia. >> >> Prasanna >> >> Michael Firstenberg wrote: >> > any pre-op medical problems? >> > Metformin pre-op? >> > >> > >> > michael >> > >> > >> > On 11/1/06, prasannasimha wrote: >> >> >> >> Double valve replacement with Tricuspid annuloplasty done 2 days >> back. >> >> Uneventful post op and extubated on 5 mics of dobutamine and >> dopamine. >> >> Started getting hyperkalemia since today 3 AM. No clinical or >> >> biochemical evidence of low output/hemolysis. Urine clear.Echo >> normal - >> >> no evidence of paravalvar leak . Lactate 2.7 mmol. Creat 1.5 mg/dL >> and >> >> BUN 43 mg/dL >> >> Initially manged hyperkalemia with Lasix , Calcium , glucose Insulin >> >> Alkalinizaation K binding resin etc but K went upto 6.8 so started >> >> PDtoday mrning. K+ dropped to 5.1 but now despite good extraction >> on PD >> >> , good urine etc last K+ just done now is 6.0. Cannot identify the >> cause >> >> of such persistant hyperkalemia. I have removed all nephrotoxic >> drugs. >> >> No additional K + sources and I have specifically asked K free diet. >> >> Any ideas/suggestions. >> >> Prasanna >> >> >> >> _______________________________________________ >> >> OpenHeart-L mailing list >> >> >> >> Send postings to: >> >> OpenHeart-L@lists.hsforum.com >> >> >> >> To UNSUBSCRIBE, to CHANGE email address, or to view archives: >> >> http://mmp.cjp.com/mailman/listinfo/openheart-l >> >> >> >> All messages transmitted by the OpenHeart-L are subject to the >> policies >> >> and >> >> disclaimers posted at: >> >> http://www.hsforum.com/listdisclaim >> >> ----------------------------------------- >> >> >> > _______________________________________________ >> > OpenHeart-L mailing list >> > >> > Send postings to: >> > OpenHeart-L@lists.hsforum.com >> > >> > To UNSUBSCRIBE, to CHANGE email address, or to view archives: >> > http://mmp.cjp.com/mailman/listinfo/openheart-l >> > >> > All messages transmitted by the OpenHeart-L are subject to the >> > policies and disclaimers posted at: >> > http://www.hsforum.com/listdisclaim >> > ----------------------------------------- >> > >> _______________________________________________ >> OpenHeart-L mailing list >> >> Send postings to: >> OpenHeart-L@lists.hsforum.com >> >> To UNSUBSCRIBE, to CHANGE email address, or to view archives: >> http://mmp.cjp.com/mailman/listinfo/openheart-l >> >> All messages transmitted by the OpenHeart-L are subject to the policies >> and >> disclaimers posted at: >> http://www.hsforum.com/listdisclaim >> ----------------------------------------- >> > _______________________________________________ > OpenHeart-L mailing list > > Send postings to: > OpenHeart-L@lists.hsforum.com > > To UNSUBSCRIBE, to CHANGE email address, or to view archives: > http://mmp.cjp.com/mailman/listinfo/openheart-l > > All messages transmitted by the OpenHeart-L are subject to the > policies and disclaimers posted at: > http://www.hsforum.com/listdisclaim > ----------------------------------------- > > From benjamin.bidstrup at bigpond.com Thu Nov 2 04:43:30 2006 From: benjamin.bidstrup at bigpond.com (Ben Bidstrup) Date: Wed Nov 1 12:43:42 2006 Subject: [HSF] Persistant Hyperkalemia (OT) In-Reply-To: References: <4548B8E9.9020506@gmail.com> <4548D301.7000404@gmail.com> Message-ID: Can I ask a peripheral question? (I am going to anyway) Why are you (or your labs) mixing SI units with conventional chemistry units? >an obvious question - even though I know you are a very good doctor (and not >just a great surgeon) - no compartment syndrome anywhere? (arm from a-line, >legs). The lactate is also concerning? I have seen this a few times, just >kinda goes away and never really sure why. > >michael > > >On 11/1/06, prasannasimha wrote: >> >>No not on Metformin (Not a diabetic) or any Aldosterone inhibitors, >>NSAID's , Aminoglycosides withdrawn. No known preop problem to cause >>hyperkalemia. >> >>Prasanna >> >>Michael Firstenberg wrote: >>> any pre-op medical problems? >>> Metformin pre-op? >>> >>> >>> michael >>> >>> >>> On 11/1/06, prasannasimha wrote: >>>> >>>> Double valve replacement with Tricuspid annuloplasty done 2 days back. >>>> Uneventful post op and extubated on 5 mics of dobutamine and dopamine. >>>> Started getting hyperkalemia since today 3 AM. No clinical or >>>> biochemical evidence of low output/hemolysis. Urine clear.Echo normal - >>>> no evidence of paravalvar leak . Lactate 2.7 mmol. Creat 1.5 mg/dL and >>>> BUN 43 mg/dL >>>> Initially manged hyperkalemia with Lasix , Calcium , glucose Insulin >>>> Alkalinizaation K binding resin etc but K went upto 6.8 so started >>>> PDtoday mrning. K+ dropped to 5.1 but now despite good extraction on PD >>>> , good urine etc last K+ just done now is 6.0. Cannot identify the >>cause >>>> of such persistant hyperkalemia. I have removed all nephrotoxic drugs. >>>> No additional K + sources and I have specifically asked K free diet. >>>> Any ideas/suggestions. >>>> Prasanna >>>> >>>> _______________________________________________ >>>> OpenHeart-L mailing list >>>> >>>> Send postings to: >>>> OpenHeart-L@lists.hsforum.com >>>> >>>> To UNSUBSCRIBE, to CHANGE email address, or to view archives: >>>> http://mmp.cjp.com/mailman/listinfo/openheart-l >>>> >>>> All messages transmitted by the OpenHeart-L are subject to the policies >>>> and >>>> disclaimers posted at: >>>> http://www.hsforum.com/listdisclaim >>>> ----------------------------------------- >>>> >>> _______________________________________________ >>> OpenHeart-L mailing list >>> >>> Send postings to: >>> OpenHeart-L@lists.hsforum.com >>> >>> To UNSUBSCRIBE, to CHANGE email address, or to view archives: >>> http://mmp.cjp.com/mailman/listinfo/openheart-l >>> >>> All messages transmitted by the OpenHeart-L are subject to the >>> policies and disclaimers posted at: >>> http://www.hsforum.com/listdisclaim >>> ----------------------------------------- >>> >>_______________________________________________ >>OpenHeart-L mailing list >> >>Send postings to: >>OpenHeart-L@lists.hsforum.com >> >>To UNSUBSCRIBE, to CHANGE email address, or to view archives: >>http://mmp.cjp.com/mailman/listinfo/openheart-l >> >>All messages transmitted by the OpenHeart-L are subject to the policies >>and >>disclaimers posted at: >>http://www.hsforum.com/listdisclaim >>----------------------------------------- >> >_______________________________________________ >OpenHeart-L mailing list > >Send postings to: >OpenHeart-L@lists.hsforum.com > >To UNSUBSCRIBE, to CHANGE email address, or to view archives: >http://mmp.cjp.com/mailman/listinfo/openheart-l > >All messages transmitted by the OpenHeart-L are subject to the >policies and disclaimers posted at: >http://www.hsforum.com/listdisclaim >----------------------------------------- -- Ben Bidstrup FRACS FRCSEd FEBCTS Consultant Cardiothoracic Surgeon From nfaabouseada at gmail.com Wed Nov 1 13:03:10 2006 From: nfaabouseada at gmail.com (Nasser F. Abou'Seada) Date: Wed Nov 1 13:03:22 2006 Subject: [HSF] Bangalore renamed In-Reply-To: <45489624.7090704@gmail.com> Message-ID: <000301c6fde0$009cb750$0801a8c0@OEM> you mean Back to the original name ???? NFA > -----Original Message----- > From: openheart-l-bounces@lists.hsforum.com [mailto:openheart-l- > bounces@lists.hsforum.com] On Behalf Of prasannasimha > Sent: Wednesday, November 01, 2006 7:42 AM > To: OpenHeart-L@lists.hsforum.com; ccm > Subject: [HSF] Bangalore renamed > > Bangalore has been renamed Bengaluru (pronounced as Bengalooru today) > (50th year of formation of the Karnataka state). > Bengalooru was the old and traditional name of Bangalore which was an > anglicized version of the original name. > The official name change will be done after publication in the Federal > Gazette. > > Prasanna > > _______________________________________________ > OpenHeart-L mailing list > > Send postings to: > OpenHeart-L@lists.hsforum.com > > To UNSUBSCRIBE, to CHANGE email address, or to view archives: > http://mmp.cjp.com/mailman/listinfo/openheart-l > > All messages transmitted by the OpenHeart-L are subject to the policies and > disclaimers posted at: > http://www.hsforum.com/listdisclaim > ----------------------------------------- From nfaabouseada at gmail.com Wed Nov 1 13:22:27 2006 From: nfaabouseada at gmail.com (Nasser F. Abou'Seada) Date: Wed Nov 1 13:22:37 2006 Subject: [HSF] Persistant Hyperkalemia In-Reply-To: <4548D73F.2060704@sify.com> Message-ID: <000401c6fde2$b17b4580$0801a8c0@OEM> what was the preop diagnosis ? .. preop condition ? .. what is her urine K+ ? .. S.Mg++ ?? NFA > From: psimha > Yes - ruled out compartment syndromes (as a part of hyperkalemia > examination) (Very relevant question and worth reiterating) > Lactate is normal now. > Found out now that Heparin can cause Aldosterone inhibition so stopped > that too (in the flushes ) though I do not think that the small doses in > the flushes should really matter. > Latest K is 5.3 after dialysis (peritoneal) and a GI drip.(Got tired of > my resident phoning me a value above 6.0) > Prasanna > Michael Firstenberg wrote: > > an obvious question - even though I know you are a very good doctor > > (and not > > just a great surgeon) - no compartment syndrome anywhere? (arm from > > a-line, > > legs). The lactate is also concerning? I have seen this a few times, > > just > > kinda goes away and never really sure why. > > michael > > On 11/1/06, prasannasimha wrote: > >> No not on Metformin (Not a diabetic) or any Aldosterone inhibitors, > >> NSAID's , Aminoglycosides withdrawn. No known preop problem to cause > >> hyperkalemia. > >> Prasanna > >> Michael Firstenberg wrote: > >> > any pre-op medical problems? > >> > Metformin pre-op? > >> > michael > >> > On 11/1/06, prasannasimha wrote: > >> >> Double valve replacement with Tricuspid annuloplasty done 2 days > >> back. > >> >> Uneventful post op and extubated on 5 mics of dobutamine and > >> dopamine. > >> >> Started getting hyperkalemia since today 3 AM. No clinical or > >> >> biochemical evidence of low output/hemolysis. Urine clear.Echo > >> normal - > >> >> no evidence of paravalvar leak . Lactate 2.7 mmol. Creat 1.5 mg/dL > >> and > >> >> BUN 43 mg/dL > >> >> Initially manged hyperkalemia with Lasix , Calcium , glucose Insulin > >> >> Alkalinizaation K binding resin etc but K went upto 6.8 so started > >> >> PDtoday mrning. K+ dropped to 5.1 but now despite good extraction > >> on PD > >> >> , good urine etc last K+ just done now is 6.0. Cannot identify the > >> cause > >> >> of such persistant hyperkalemia. I have removed all nephrotoxic > >> drugs. > >> >> No additional K + sources and I have specifically asked K free diet. > >> >> Any ideas/suggestions. > >> >> Prasanna From nfaabouseada at gmail.com Wed Nov 1 13:25:09 2006 From: nfaabouseada at gmail.com (Nasser F. Abou'Seada) Date: Wed Nov 1 13:25:17 2006 Subject: [HSF] Persistant Hyperkalemia (OT) In-Reply-To: Message-ID: <000501c6fde3$11830300$0801a8c0@OEM> Great Surgeons are essentially Great Doctors .... who operate .... Surgeons who ae not physicians .... risk being no more than manual workers ..!!!! NFA > > >an obvious question - even though I know you are a very good doctor (and not > >just a great surgeon) - no compartment syndrome anywhere? (arm from a-line, > >legs). The lactate is also concerning? I have seen this a few times, just > >kinda goes away and never really sure why. > > > >michael > > > > > >On 11/1/06, prasannasimha wrote: > >> > >>No not on Metformin (Not a diabetic) or any Aldosterone inhibitors, > >>NSAID's , Aminoglycosides withdrawn. No known preop problem to cause > >>hyperkalemia. > >> > >>Prasanna > >> > >>Michael Firstenberg wrote: > >>> any pre-op medical problems? > >>> Metformin pre-op? > >>> > >>> > >>> michael > >>> > >>> > >>> On 11/1/06, prasannasimha wrote: > >>>> > >>>> Double valve replacement with Tricuspid annuloplasty done 2 days back. > >>>> Uneventful post op and extubated on 5 mics of dobutamine and dopamine. > >>>> Started getting hyperkalemia since today 3 AM. No clinical or > >>>> biochemical evidence of low output/hemolysis. Urine clear.Echo normal - > >>>> no evidence of paravalvar leak . Lactate 2.7 mmol. Creat 1.5 mg/dL and > >>>> BUN 43 mg/dL > >>>> Initially manged hyperkalemia with Lasix , Calcium , glucose Insulin > >>>> Alkalinizaation K binding resin etc but K went upto 6.8 so started > >>>> PDtoday mrning. K+ dropped to 5.1 but now despite good extraction on PD > >>>> , good urine etc last K+ just done now is 6.0. Cannot identify the > >>cause > >>>> of such persistant hyperkalemia. I have removed all nephrotoxic drugs. > >>>> No additional K + sources and I have specifically asked K free diet. > >>>> Any ideas/suggestions. > >>>> Prasanna > >>>> > >>>> _______________________________________________ > >>>> OpenHeart-L mailing list > >>>> > >>>> Send postings to: > >>>> OpenHeart-L@lists.hsforum.com > >>>> > >>>> To UNSUBSCRIBE, to CHANGE email address, or to view archives: > >>>> http://mmp.cjp.com/mailman/listinfo/openheart-l > >>>> > >>>> All messages transmitted by the OpenHeart-L are subject to the policies > >>>> and > >>>> disclaimers posted at: > >>>> http://www.hsforum.com/listdisclaim > >>>> ----------------------------------------- > >>>> > >>> _______________________________________________ > >>> OpenHeart-L mailing list > >>> > >>> Send postings to: > >>> OpenHeart-L@lists.hsforum.com > >>> > >>> To UNSUBSCRIBE, to CHANGE email address, or to view archives: > >>> http://mmp.cjp.com/mailman/listinfo/openheart-l > >>> > >>> All messages transmitted by the OpenHeart-L are subject to the > >>> policies and disclaimers posted at: > >>> http://www.hsforum.com/listdisclaim > >>> ----------------------------------------- > >>> > >>_______________________________________________ > >>OpenHeart-L mailing list > >> > >>Send postings to: > >>OpenHeart-L@lists.hsforum.com > >> > >>To UNSUBSCRIBE, to CHANGE email address, or to view archives: > >>http://mmp.cjp.com/mailman/listinfo/openheart-l > >> > >>All messages transmitted by the OpenHeart-L are subject to the policies > >>and > >>disclaimers posted at: > >>http://www.hsforum.com/listdisclaim > >>----------------------------------------- > >> > >_______________________________________________ > >OpenHeart-L mailing list > > > >Send postings to: > >OpenHeart-L@lists.hsforum.com > > > >To UNSUBSCRIBE, to CHANGE email address, or to view archives: > >http://mmp.cjp.com/mailman/listinfo/openheart-l > > > >All messages transmitted by the OpenHeart-L are subject to the > >policies and disclaimers posted at: > >http://www.hsforum.com/listdisclaim > >----------------------------------------- > > > -- > Ben Bidstrup FRACS FRCSEd FEBCTS > Consultant Cardiothoracic Surgeon > _______________________________________________ > OpenHeart-L mailing list > > Send postings to: > OpenHeart-L@lists.hsforum.com > > To UNSUBSCRIBE, to CHANGE email address, or to view archives: > http://mmp.cjp.com/mailman/listinfo/openheart-l > > All messages transmitted by the OpenHeart-L are subject to the policies and > disclaimers posted at: > http://www.hsforum.com/listdisclaim > ----------------------------------------- From setserclan at adelphia.net Wed Nov 1 19:10:07 2006 From: setserclan at adelphia.net (Ed Setser) Date: Wed Nov 1 19:10:13 2006 Subject: [HSF] Persistant Hyperkalemia References: <4548B8E9.9020506@gmail.com> <4548D301.7000404@gmail.com> <4548D73F.2060704@sify.com> Message-ID: <004001c6fe13$414eb9f0$6401a8c0@OZ> peri-op adrenal insufficiency? ----- Original Message ----- From: "psimha" To: Sent: Wednesday, November 01, 2006 12:19 PM Subject: Re: [HSF] Persistant Hyperkalemia > Yes - ruled out compartment syndromes (as a part of hyperkalemia > examination) (Very relevant question and worth reiterating) > Lactate is normal now. > Found out now that Heparin can cause Aldosterone inhibition so stopped > that too (in the flushes ) though I do not think that the small doses in > the flushes should really matter. > Latest K is 5.3 after dialysis (peritoneal) and a GI drip.(Got tired of my > resident phoning me a value above 6.0) > Prasanna > Michael Firstenberg wrote: >> an obvious question - even though I know you are a very good doctor (and >> not >> just a great surgeon) - no compartment syndrome anywhere? (arm from >> a-line, >> legs). The lactate is also concerning? I have seen this a few times, >> just >> kinda goes away and never really sure why. >> >> michael >> >> >> On 11/1/06, prasannasimha wrote: >>> >>> No not on Metformin (Not a diabetic) or any Aldosterone inhibitors, >>> NSAID's , Aminoglycosides withdrawn. No known preop problem to cause >>> hyperkalemia. >>> >>> Prasanna >>> >>> Michael Firstenberg wrote: >>> > any pre-op medical problems? >>> > Metformin pre-op? >>> > >>> > >>> > michael >>> > >>> > >>> > On 11/1/06, prasannasimha wrote: >>> >> >>> >> Double valve replacement with Tricuspid annuloplasty done 2 days >>> back. >>> >> Uneventful post op and extubated on 5 mics of dobutamine and >>> dopamine. >>> >> Started getting hyperkalemia since today 3 AM. No clinical or >>> >> biochemical evidence of low output/hemolysis. Urine clear.Echo >>> normal - >>> >> no evidence of paravalvar leak . Lactate 2.7 mmol. Creat 1.5 mg/dL >>> and >>> >> BUN 43 mg/dL >>> >> Initially manged hyperkalemia with Lasix , Calcium , glucose Insulin >>> >> Alkalinizaation K binding resin etc but K went upto 6.8 so started >>> >> PDtoday mrning. K+ dropped to 5.1 but now despite good extraction >>> on PD >>> >> , good urine etc last K+ just done now is 6.0. Cannot identify the >>> cause >>> >> of such persistant hyperkalemia. I have removed all nephrotoxic >>> drugs. >>> >> No additional K + sources and I have specifically asked K free diet. >>> >> Any ideas/suggestions. >>> >> Prasanna >>> >> >>> >> _______________________________________________ >>> >> OpenHeart-L mailing list >>> >> >>> >> Send postings to: >>> >> OpenHeart-L@lists.hsforum.com >>> >> >>> >> To UNSUBSCRIBE, to CHANGE email address, or to view archives: >>> >> http://mmp.cjp.com/mailman/listinfo/openheart-l >>> >> >>> >> All messages transmitted by the OpenHeart-L are subject to the >>> policies >>> >> and >>> >> disclaimers posted at: >>> >> http://www.hsforum.com/listdisclaim >>> >> ----------------------------------------- >>> >> >>> > _______________________________________________ >>> > OpenHeart-L mailing list >>> > >>> > Send postings to: >>> > OpenHeart-L@lists.hsforum.com >>> > >>> > To UNSUBSCRIBE, to CHANGE email address, or to view archives: >>> > http://mmp.cjp.com/mailman/listinfo/openheart-l >>> > >>> > All messages transmitted by the OpenHeart-L are subject to the >>> > policies and disclaimers posted at: >>> > http://www.hsforum.com/listdisclaim >>> > ----------------------------------------- >>> > >>> _______________________________________________ >>> OpenHeart-L mailing list >>> >>> Send postings to: >>> OpenHeart-L@lists.hsforum.com >>> >>> To UNSUBSCRIBE, to CHANGE email address, or to view archives: >>> http://mmp.cjp.com/mailman/listinfo/openheart-l >>> >>> All messages transmitted by the OpenHeart-L are subject to the policies >>> and >>> disclaimers posted at: >>> http://www.hsforum.com/listdisclaim >>> ----------------------------------------- >>> >> _______________________________________________ >> OpenHeart-L mailing list >> >> Send postings to: >> OpenHeart-L@lists.hsforum.com >> >> To UNSUBSCRIBE, to CHANGE email address, or to view archives: >> http://mmp.cjp.com/mailman/listinfo/openheart-l >> >> All messages transmitted by the OpenHeart-L are subject to the policies >> and disclaimers posted at: >> http://www.hsforum.com/listdisclaim >> ----------------------------------------- >> >> > > _______________________________________________ > OpenHeart-L mailing list > > Send postings to: > OpenHeart-L@lists.hsforum.com > > To U