[HSF] type A aortic dissection

[erdinç naseri]

Dear Tom,
The patient had CABG previously so the sternotomy is not a virgin one..


>From: Tdmartin2000 <tdmartin2000 at aol.com>
>Reply-To: OpenHeart-L at lists.hsforum.com
>To: OpenHeart-L at lists.hsforum.com
>Subject: Re: [HSF] type A aortic dissection
>Date: Sun, 11 Feb 2007 23:04:31 -0500
>
>If it is a virgin sternotomy why would you need to cannulate the femoral 
>vein? I can understand not cannulating the aorta, but why not cannulate the 
>atrium to begin with. In the past several yrs I have almost routinely 
>cannulated the aorta also on most acute dissections. You can see where the 
>aorta is not dissected and where the true lumen is on CT and confirm the 
>exact cannulation site with epiaortic imaging if available. Curt Tribble 
>tells me that he has cannulated the ascending on acute sessections for yrs 
>even without knowing where the true lumen is. (Curt- if you read this and 
>this is not totally true please correct me). \
>
>Tom Martin
>U of Florida
>Gainesville
>
>
>
>In a message dated 02/11/07 08:27:09 Eastern Standard Time, Hgrmd writes:
>Erdin,
>  Is ACP antegrade cerebral perfusion?  If so, how will you  do it,
>particularly with freshly dissected tissues?  Also, if you use a  long 
>femoral venous
>cannula that is directed into the SVC under TEE control,  there is no need 
>to
>later convert to right atrial cannulation.  Finally,  your hope of 
>reimplanting
>the vein grafts as an island is likely to be  unsuccessful since parts of
>their origins are likely to be dissected.  I  would harvest extra vein in 
>case
>you have to make a few short interposition  grafts.  Otherwise, your plan 
>looks
>pretty sound.
>Hal
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