AW: [HSF] Persistence of mammary branches and post
CABGangina:whichisthe truth?
V. Aldrete, M.D.
valdretemd at shaw.ca
Thu Jul 5 14:30:54 EDT 2007
Keeping with this thread. Intercostal steal phenoma is not only
possible in practice, but it is also explainable in physiology.
Coronary blood flow occurs mostly during diastole, but is not
completely absent during systole. The reason is that the pressure of
the myocardial wall varies from endothelium to epicardium related to
the physics of tension in a sphere, whereas the systolic pressure is
identical to the intraventricular pressure in the endothelium, that
is not the case to the epicardium, where the pressure is slightly
less than peak systolic, thus coronary flow can and does occur in
systole to areas of the epicardium throughout the ventricules. R.
Baird out of Toronto did extensive research back in the early and
middle 70's regarding intramyocardial tissue pressures under a number
of physiological circumstances, such as a beating heart, empty
beating heart, fibrillating heart, etc. Most of his research was
published in Circulation Research.
Hope this completes this issue, but if you really need the citations
I am afraid I presently do not have the time to look for them
Cheers,
Victor
On Jul 4, 2007, at 12:10 PM, Dr. Roberto Battellini wrote:
> Tea, Ani, Rodriguez-Campos,all
>
> I have read many articles, some pro, some contra. The described
> cases of
> positive angina show a very, very big first intercostal artery in a
> reangio,
> located very high, and the patients have relief of their angina after
> ligating or coiling them. In 2 descriptions, after intravascular
> coiling,
> the patients had angina again, then a reangio showed the big
> intercostal
> artery open, again recoiled in one and ligated in other, the
> patients had no
> more angina. The patients were studied with thallium scintigraphy.
> In papers which do not recognize this RARE but possible problem, the
> authors hadn´t seen such a case, they write wonderful
> phisiopathologic
> comments valid for the majority of the cases, but they did studies in
> patients with smaller collaterals. Even Calafiore does not deny this
> possibility.
> Case reports: Constantin von zur Mühlen 2006, Marco Pocar JTCVS 2005,
> Sebastian Pagni ATS 2001, Renee Hartz ATS 1997, P.K.Spanos 1998,
> Pelias A
> JTCVS 1985, Mishekel in Cateth Cardiovasc Diag 1992,Sharouni Cath
> Cardiovasc Diag 1994
> Negative comments: Luise-Calafiore 1997, Calafiore ATS 1998, Claudio
> Pragliola JTCVS 1999, Mario Gaudino EJCTS 1999, Morton Kern:
> Editorial ATS
> 1999
> Interesting: Gaudino ATS 1998:" this possibility seems to be
> minimal", but
> he doesn´t discard it.
> I believe that it could be in cases when this lateral costal artery is
> bigger than the LIMA. If you look at the angios in these case
> reports, the
> lateral costal artery is very big...
>
> Roberto
>
> -----Ursprüngliche Nachricht-----
> Von: openheart-l-bounces at lists.hsforum.com
> [mailto:openheart-l-bounces at lists.hsforum.com] Im Auftrag von Tea
> Acuff
> Gesendet: Mittwoch, 4. Juli 2007 14:59
> An: OpenHeart-L at lists.hsforum.com
> Betreff: Re: [HSF] Persistence of mammary branches and post
> CABGangina:whichisthe truth?
>
> I believe...but not very much. Sorry for the double negatives.
> tea
>
>
> ----- Original Message ----
> From: A <alsadd at ksu.edu.sa>
> To: OpenHeart-L at lists.hsforum.com
> Sent: Wednesday, July 4, 2007 11:42:12 AM
> Subject: RE: [HSF] Persistence of mammary branches and post
> CABGangina:whichis the truth?
>
>
> Tea:
> Thank you for your response but please allow to plead ignorance.
> Are you
> with me or do you believe that a mammary branch can cause a steal
> phenomenon?
> In all honesty your English is too perfect I envy you
>
> Ahmed
>
> -----Original Message-----
> From: openheart-l-bounces at lists.hsforum.com
> [mailto:openheart-l-bounces at lists.hsforum.com] On Behalf Of Tea Acuff
> Sent: Tuesday, July 03, 2007 5:00 PM
> To: OpenHeart-L at lists.hsforum.com
> Subject: Re: [HSF] Persistence of mammary branches and post
> CABGangina:whichis the truth?
>
> I don't doubt you (I believe), but it is unlikely common among either
> successful or failed Lima to LAD grafts.
>
> tea
>
>
> ----- Original Message ----
> From: A <alsadd at ksu.edu.sa>
> To: OpenHeart-L at lists.hsforum.com
> Sent: Tuesday, July 3, 2007 4:02:13 PM
> Subject: RE: [HSF] Persistence of mammary branches and post CABG
> angina:whichis the truth?
>
>
> I tend to agree with Calafiore and others I am sure would to.
>
> Ahmed
>
> -----Original Message-----
> From: openheart-l-bounces at lists.hsforum.com
> [mailto:openheart-l-bounces at lists.hsforum.com] On Behalf Of Dr.
> Roberto
> Battellini
> Sent: Monday, July 02, 2007 3:31 AM
> To: OpenHeart-L at lists.hsforum.com
> Subject: AW: [HSF] Persistence of mammary branches and post CABG
> angina:whichis the truth?
>
> Well, you have the 4th case I read upon, another from Donald Ross,
> so I have
> to believe it.
> Roberto
>
> -----Ursprüngliche Nachricht-----
> Von: openheart-l-bounces at lists.hsforum.com
> [mailto:openheart-l-bounces at lists.hsforum.com] Im Auftrag von Jorge
> Rodriguez Campos
> Gesendet: Freitag, 15. Juni 2007 17:17
> An: OpenHeart-L at lists.hsforum.com
> Betreff: Re: [HSF] Persistence of mammary branches and post CABG
> angina:
> whichis the truth?
>
> Dear Roberto:
> I had a case who had 2 years post-
> op angina
> with exercise, he had in angio a large lateral thoracic ima branch,
> he was
> cured wend a ima branch embolised.-
> Dr. Jorge Rodriguez
> Campos
>
> "Dr. Roberto Battellini" <battr at medizin.uni-leipzig.de> escribió:
>
>
> Dear Members,
> I am revisiting this subject. There are some case reports telling
> it is
> truth, but Calafiore insists in the diastolic flow through the IMA and
> systolic through the branches, so physiologically could not happen.
> I have the literature from ctsnet.org, what I want is the personal
> experience and scientific thoughts from our members. EBA, for example,
> hallo, Tea.. (or literature "not-ctsnet")
> Roberto
>
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