[HSF] anomolous RCA

[Tea Acuff]

Would depend on what the actual anatomy is...see Novick's comment. CAB is always a fall back option, if necessary.
tea


----- Original Message ----
From: prasannasimha <prasannasimha at gmail.com>
To: OpenHeart-L at lists.hsforum.com
Sent: Monday, February 5, 2007 7:44:12 PM
Subject: Re: [HSF] anomolous RCA


Tea would Hal be comfortable with RCA transposition. Most of these have 
been grafting as the anomalous coronary doesn't lend a good "arc" for 
transposition.
Prasanna

Tea Acuff wrote:
> With that anatomy, what you propose should work. If you did a primary transposition, you would do it anteriorly anyway. Your radiologist does not know anything about coronary disease. His risk of dying from a small RCA is approximately the risk of the operation. It should fix his symptoms, however.
> tea
>
>
> ----- Original Message ----
> From: "Hgrmd at aol.com" <Hgrmd at aol.com>
> To: OpenHeart-L at lists.hsforum.com
> Sent: Monday, February 5, 2007 6:12:19 PM
> Subject: Re: [HSF] anomolous RCA
>
>
> Chand,
>   I wish I could show you the 64 slice CT scan.  It clearly shows  an RCA 
> arising from the left coronary sinus.  It appears to be a string  during its 
> course between the left side of the ascending aorta and the right  side of the 
> MPA.  Distally, it appears normal caliber and terminates in a  nice PDA.  I don't 
> see much of a posterolateral branch, and suspect it is a  codominant system.  
> The LM, LAD, and Cx appear unremarkable. The  radiologist interprets the scan 
> as an anomolous RCA with a "potentially lethal"  anatomy.  I've referred the 
> case to a cardiologist I trust and will get his  opinion regarding the need 
> for a cath.  Quite honestly, though I don't have  much experience in 
> interpreting 64 slice scans, this appears to be an excellent  study.  The patient has had 
> exertional angina that began about a month  ago.  Interestingly, a nuclear 
> scan reveals mild anterior  reversibility.  
>   My initial plan is to place a RIMA to the RCA and probably close the  RCA 
> at its course between the aorta and the PA.  Looks to me that  mobilizing the 
> RCA off the left sinus would be a dangerous royal pain. Any other  suggestions?
> Hal
> _______________________________________________
> 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
> -----------------------------------------
> _______________________________________________
> 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
> -----------------------------------------
>
>   
_______________________________________________
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
-----------------------------------------