[HSF] anomolous RCA

[Tea Acuff]

I might be concerned with that although it will likely work. What are his age, symptoms and how big is the RCA? This may seem odd, (but so are other of my thoughts) I would consider the following. Do you have a CT or other study to confirm or just quessing by the shape of the angiogram? If the only thing that you are worried about is "compression" a bare stent may protect the same and "restenosis" would then be likely safe and its solution both straight forward and predictable. If that is not to be considered, I would keep my options open. A tranposition of the proximal RCA to the anterior aorta would be ideal if it is obvious. I might prefer a likely very short vein if the RCA is large to avoid acute ischemia if ligation is planned and spasm if not.
tea 


----- Original Message ----
From: "hgrmd at aol.com" <hgrmd at aol.com>
To: OpenHeart-L at lists.hsforum.com
Sent: Monday, February 5, 2007 2:24:43 PM
Subject: [HSF] anomolous RCA


Dear Members,
  I was recently referred a case of a man with an anomolous takeoff of the RCA.  It originates from the left main and courses between the aorta and the PA.  My plan is to graft the RCA with a RIMA.  Do I need to occlude the RCA between the aorta and PA so as to eliminate competitive flow?
Hal
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