[HSF] Aortic Aneurysms and Bicuspid Valves

[Hgrmd at aol.com]

Ed,
  Of course, I went on pump prior to splitting the sternum.  I  would never 
consider doing a Bentall through the right chest, because I'm  already paranoid 
about implanting the buttons, etc. through the  conventional approach.  I 
could envision that a bleeder on the distal  anatomosis by the pulmonary artery 
would be unfixable from the right  chest.  
  The CT showed that the aneurysm was very close to the sternum.   However, 
with it somewhat decompressed by CPB, I was able to avoid gooning it  with the 
saw.  Even if I had, by virtue of being on CPB, I should have been  able to 
rapidly dissect out enough of the aorta to regain control before the  patient 
bled out.  In fact, I had that happen a few months ago and was able  to regain 
control fairly rapidly.  If I hadn't been on CPB, game  over.
Hal