[HSF] Trip to Croatia

[prasannasimha]

As Bojan said we were already at 22 Deg and I did not have any real 
problem using high/low flows as required so I just proceeded. Replacing 
the balloon was a very viable option but I was comfortable with what I 
was doing so did not bother.
In fact , Hal, I did ask if a Heart Port endoballoon was available.(You 
never know what is available in a particular hospital unless you ask for 
it !!) I would have used it if  it is available but did not regret it 
when it was not available (I anyway do not have access to it ) . In the 
Hospital they had many things that I did not have like fibrin glue , 
excellent blood bank resources , cell savers etc. So, I while I may ask 
for things that I did not have, my policy is always to make do with what 
I have - if you have more - good but if you haven't then make  up an 
alternative.The Foley's catheter is a cheap and useful adjunct and as 
Bojan said, we can measure the pressure which I did not (I just did it 
by "feel" during inflation and seeing occlusion with the TEE).
I did not give the cardioplegia via the Foley's but via another cannula 
just as my comfort level was easier with a second needle which did not 
need any other dissection anyway. (Worried always of kinking of the soft 
Foley's causing issues by the perfusionist who may complain of increased 
pressure / resistance etc)
Prasanna
bbiocina at kbd.hr wrote:
> Hal ,
> although we have already been  quite  flexible in our practice since
> early 90's in managing patients with little  of resources available  (
> war in the region etc.), Prasanna's visit opened  to us the whole new
> world of flexibility  which I think  it will be  succesfully applied in
> daily practice , even with much more generous resources available now.
> The reason we did not replace the baloon was( I think , I hope that
> Prasanna agrees) that the part of the procedure  which required 
> clamping was  relatively short anyway ( additional pledgeted sutures) ,
> and it  could have  been succesfully managed with alterations of flow (
> at 22 degrees systemic).
> You can monitor  the pressure in Foley , too. Although the inlet valve 
> is one-way , you can go trough it  with a needle  connected  to a
> pressure line ( I did that in the past , not during this case)
>
> Bojan
>
> On 4/7/2007, "Hgrmd at aol.com" <Hgrmd at aol.com> wrote:
>
>   
>> Bohan,
>>  My hat's off to your team for ingenuity.  If the Foley balloon  was
>> ruptured, why didn't you just replace it through the pursestring?
>>  One word of caution, though.  With the Heartport balloon, you  can monitor
>> the pressure and prevent overinflation.
>> Hal
>>
>>
>>
>> ************************************** See what's free at http://www.aol.com.
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