[HSF] aortic root replacement ,svere hyperbilirubinemia

[Hgrmd at aol.com]

Prasanna,
  I've done plenty of AVR's through a 6 cm upper hemisternotomy.   I make an 
"L" shaped sternotomy checked off into the right 4th ICS.  I use  a neuro saw 
to make that fine little cut across the interspace.  I've yet  to injure the 
RIMA with this approach.  I use femoral cannulation and  Heartport retrograde.  
Works well.  However, I've never had the balls  to use this approach for a 
Bentall.  I've certainly read the reports, but a  full Bentall with hemiarch or 
arch replacement takes me long enough via a full  sternotomy.  I think my 
sphincter tone would only be audible by dogs if I  tried doing a Bentall through a 
keyhole.
 
Hal



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