[HSF] LAD ENDARTERECTOMY

[erdinç naseri]

In some of the patients with diffuse coronary atherosclerosis neccessitating 
patch angioplasty you must do endarterectomy to be able to pass the needle 
safely.Once you have done  a local endarterectomy it is better to extend it 
as far as possible to have  a smooth distal transitional point.
Erdinc Naseri


>From: "murali vettath" <mvettathcts at hotmail.com>
>Reply-To: OpenHeart-L at lists.hsforum.com
>To: OpenHeart-L at lists.hsforum.com
>Subject: Re: [HSF] LAD ENDARTERECTOMY
>Date: Thu, 11 Jan 2007 20:22:50 -0700
>
>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
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