AW: [HSF] a carotid and coronary case

[erdinç naseri]

Hal,
In a situation with total occlusion of one carotid and 75% of the other the below mwntioned safety measures can decrease the risk of stroke due to cerebral hypoperfusion:
1.preop cerebral angiography to show the patency of the posterior system and completeness of the circle of Willis.
2.Intraop monitoring of the cerebral circulation:
  I.CEA under regional anesthesia and while the patients talks during the procedure.
  II.CEA under GA but with EEG monitoring and evaluation in experienced hands.
3.Total  external body cooling to moderate hypothermia( I use Heater-cooler of H-L machine)
4.Strict stabilization of the MAP at  hypertensive levels.
erdinc> From: Hgrmd at aol.com> Date: Sat, 4 Aug 2007 09:09:12 -0400> Subject: Re: AW: [HSF] a carotid and coronary case> To: OpenHeart-L at lists.hsforum.com> CC: > > Prasanna,> Let me answer your question with a question. With 3/4 occluded vessels > and no CAD, would you favor CEA with DHCA? Of course not. You would merely > shunt and patch. That's what you should do with a combined procedure.> > Hal> > > > ************************************** Get a sneak peek of the all-new AOL at > http://discover.aol.com/memed/aolcom30tour> _______________________________________________> OpenHeart-L mailing list> > Send postings to:> OpenHeart-L at 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> -----------------------------------------