[HSF] Posterior extension of conventional LA incision revisited

[Nasser F. Abou'Seada]

Dear Hal 
Yes .... I'd agree with you about that tendency. in fact this was the
essential idea of C. Duran - when I was his assistant. He wrote a lot about
that subject. the consensus was that patients who were in preoperative SR
would return to ATRIAL rhythm before hospital discharge. What I have
experienced was that the rhythm consequences were NOT related to SAN
dysfunction resulting from the SSI, as a single responsible variable
"anecdotal", and that, the observation that severance of the SAN artery was
NOT related to SAN dysfunction postoperatively; holds true. 

IMHO, many other variables come to play, including: method of myocardial
salvage, myocardial perfusion / reperfusion duration, size of LA, size or
RA, ??? Atrial fatigue "in Prasanna's  terms!!", preoperative functional
status of the patient, Condition of the myocardium, and most importantly, to
my mind, detailed technique of the incision, and its "reconstruction" -would
prefer it to repair.. !- ...

NFA

> From: Hgrmd at aol.com
> Bob,
>   I think a lot of it is the reluctance of most of my cardiologists to
send
> patients home in a slow junctional rhythm.  I realize that, with time,  SA
> node function can return.  However, the tendency is to leave the  patients
in the
> hospital until the issue is resolved.
> Hal