[HSF] On pump beating heart

[Ani Anyanwu]

Presumably with Salerno's technique you could have done mitral without clamping, though I doubt Salerno would advocate doing the mitral in this particular case. The patients critical lesion is her CAD and that is what (s)he came to the OR emergently for. Was it ischemic MR? What was the MR post-bypass.

Thank you

Ani
  ----- Original Message ----- 
  From: Dr. Roberto Battellini<mailto:battr at medizin.uni-leipzig.de> 
  To: 'OpenHeart-L'<mailto:OpenHeart-L at hsforum.com> 
  Sent: Thursday, February 15, 2007 12:36 PM
  Subject: AW: [HSF] On pump beating heart


  Today I have done our N° 50 case of sever atherosclerotic aorta + 2-3 vessel
  disease. The patient , 83 years old, was unstable, and with 3 vessel disease
  + left main, MI I grade. In TEE we recognized MI II grade. I canulated the
  axyllary artery, as the whole aorta was calcified. Went on pump, did
  LIMA-LAD and veins to obtuse marginal and RCA. The heart fibrillated by
  doing the obtuse marginal, after which could be easily defibrillated. I
  anastomosed the veins to the innominate artery (truncus) at 34 degrees.
  Sorry, Hal, I did not touch the Mitral.

  He came out of pump without drugs, he is now awake at ICU waiting to be
  extubated.

   

  I remembered that email from Tea, and want to know what is he doing in these
  cases. Hal, would you have done aortic replacement on DHCA to just access to
  the mitral?

   

  We presented our experience last week with 49 cases in Hamburg.

  Roberto

   

    _____  

  Von: OpenHeart-L at hsforum.com<mailto:OpenHeart-L at hsforum.com> [mailto:OpenHeart-L at hsforum.com] Im Auftrag von
  Tea Acuff
  Gesendet: Montag, 22. Juli 2002 15:23
  An: OpenHeart-L
  Betreff: Re: [HSF] On pump beating heart

   

  Just a few clarifications.  I have experienced acute ischemia (or at least
  what we attribute to be acute ischemia). My point is not that never occurs,
  but it is that I am very poor at predicting when it will occur and have been
  amazed at the cases it did not (since I violate most of the "rules").  If I
  am suspicious, I will precondition as a test (which frequently passes), I
  don't like to shunt. I pace the RCA if necessary. If I can't position an
  important vessel, I will add RV support or CPB.  I think that a beating
  heart techique "de-embolizes" the vessel much better than retrograde
  cardioplegia for redo's and avoids a sometimes difficult cross clamp.  We
  should think first beating heart and secondarily off pump unless there is a
  specific reason to avoid the pump eg bad aorta, bad lungs, emergency on
  anticoagulants,etc.
  Tea Acuff

   

  In a message dated 7/21/02 6:02:17 PM Central Daylight Time,
  mkcd at comcast.net<mailto:mkcd at comcast.net> writes:






  On pump and full Myocardial arrest although there are several surgeons who
  advocate going on pump for hemodynamic support then doing beating heart
  assisted. Anyone with this approach care to share your experience with us ?

  Mercedes





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