[HSF] Posterior aortic bleed and Coronarybutton tears.

[Nasser F. Abou'Seada]

> I have manaed several posterior aortic bleeds resulting from ----- or at
the lower end of the aortotomy carried deep into the noncoronary sinus by
diverting them into the left atrium. With the patient on bypass,  an
incision is made in the roof to the left atrium
> and the edge sutured to the aortic root distal to the leaking area.

Dear John 
I find that very interesting, though not comprehending what you do exactly.
would you elaborate more on your technique here please .. ?

NFA

> -----Original Message-----
> From: openheart-l-bounces at lists.hsforum.com [mailto:openheart-l-
> bounces at lists.hsforum.com] On Behalf Of Jbflegejr at aol.com
> Sent: Monday, October 09, 2006 4:48 PM
> To: OpenHeart-L at lists.hsforum.com
> Subject: Re: [HSF] Posterior aortic bleed and Coronarybutton tears.
> 
> I have manaed several posterior aortic bleeds resulting from too vigorous
> removal of calcium from the aortic root or at the lower end of the
aortotomy
> carried deep into the noncoronary sinus by diverting them into the left
atrium.
> With the patient on bypass,  an incision is made in the roof to the left
atrium
> and the edge sutured to the aortic root distal to the leaking area. This
has
> been lifesaving and has never resulted in a persistent fistula. I have not
done
> this in recent years having become more careful in avoiding the problem.
> Another method that I have used on occasion is gauze packing. Using one
inch
> vaginal packing, I have packed the area at the aortic root over the roof
of the
> left atrium and between the aorta and right atrium and brought the end of
the
> packing through the chest wall and after a day or two started pulling it
out a
> few inches at a time two or three times a day. Usually about three feet of
> packing was used. I never saw recurrent bleeding with either technique.
John Flege
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