[HSF] On pump beating heart

Fri Feb 16 22:30:02 EST 2007

Hey, Ed you could go the whole hog (or roo) and hang everything to  
the imas.
In some folks it is hard to fond a soft spot.
Don
On 16/02/2007, at 10:13 AM, Edward Bender wrote:

> I echo Johns praise, Roberto.  In some of my patients where the  
> aorta is heavily calcified, the is one spot somewhere on the aorta  
> that is soft.  I use epi-aortic ultrasound, and, if no exophytic  
> plaque, will use the heartstring device to sew on the top end  
> (sorry for my acquired Aussie idiom).
>
> Ed Bender, MD
>
>
> On Feb 15, 2007, at 4:43 PM, rowlesjohn at aol.com wrote:
>
>> Roberto
>>
>> Your operation for this elderly, high risk gentleman is a classic  
>> example of the less is more philosophy to facilitate an excellent  
>> outcome. Did the heart distend during the fibrillation and if so,  
>> how was it managed?
>>
>> Thanks,
>>
>> John Rowles
>>
>>
>> -----Original Message-----
>> From: battr at medizin.uni-leipzig.de
>> To: OpenHeart-L at hsforum.com
>> Sent: Thu, 15 Feb 2007 9:36 AM
>> 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] 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 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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