[HSF] LAD ENDARTERECTOMY

[Nasser F. Abou'Seada]

Dear Dr. Murali 
how far would you go for patch angioplasty in such cases?
what is the appropriate length you would go for arteriotomy ?
what sort of patch do you use ?
what graft do you prefer in such cases ?


NFA

> -----Original Message-----
> From: openheart-l-bounces at lists.hsforum.com [mailto:openheart-l-
> bounces at lists.hsforum.com] On Behalf Of murali vettath
> Sent: Thursday, January 11, 2007 10:23 PM
> To: OpenHeart-L at lists.hsforum.com
> Subject: Re: [HSF] LAD ENDARTERECTOMY
> 
> Don,
> 
> It was interesting to note that Endarterectomy is performed so
extensively,
> though most of the time the patency of the graft down the line is quite
> questionable.
> 
> i used to see them happen when I was in australia. since 1999, we have
> changed our technique after coming down to India, and we no longer perform
> endarterectomy .
> 
> though we come across a large number of diffusely diseased LAD in our day
to
> day practice, we stick to our technique of Patch angioplasty sans
> endarterectomy, there by trying to retain the intima as far as possible.
> 
> We have performed nearly 200 of such procedures so far and the absence of
> peri op infarction and the post operative angiographic results on the
> studies we have performed in patients after 2yrs have been gratifying.
> 
> We have been performing all these off pumpas with all other OPCABs
> dr Murali Vettath
> 
> 
> >From: Donald Ross <donross at bigpond.com>
> >Reply-To: OpenHeart-L at lists.hsforum.com
> >To: OpenHeart-L at lists.hsforum.com
> >Subject: Re: [HSF] LAD ENDARTERECTOMY
> >Date: Fri, 12 Jan 2007 11:18:34 +1100
> >
> >I used to do a lot of (unnecessary as it turned out) endarterectomies  to
> >clean out the proximal lad and revascularise the septals.
> >The results were good with no  problems till we changed from bubble  to
> >membrane oxygenators.
> >Then I started to have acute closures with unpleasant consequences,  due
I
> >believe to healthier platelets.
> >Needless to say I now only do occasional endarterectomies for the  same
> >indications as Gustavo and others.
> >My protocol is my usual aggressive early aspirin and clopidogrel
> >supplanted by 6 months warfarin.
> >
> >I have seen several late( > 10 years ) angiograms of that early set  with
> >patent grafts to  their enarterecomies.
> >
> >No, Thomas I have never measured flows but  they are always  done on  the
> >beating heart using one of my  long shunts.
> >Incidentally, if the shunt is held up distally it means you have more
> >prawn guts to extract.
> >Don
> >_______________________________________________
> >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
> >-----------------------------------------
> 
> _________________________________________________________________
> Get FREE Web site and company branded e-mail from Microsoft Office Live
> http://clk.atdmt.com/MRT/go/mcrssaub0050001411mrt/direct/01/
> 
> _______________________________________________
> 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
> -----------------------------------------