[HSF] Post-op arrest

[A]

Don:
I would bit that the VT is due to the stenosed Lima. I believe that a
stenosed graft would reveal itself by low flow when the flow is measured at
surgery. We do that routinely in our practice. I would probably take him and
put a vein graft distal to stenosed Lima  anastamosis. Because VT can happen
again and could prove fatal. 
That is what comes to my mind now. Others in the forum might disagree with
me I look forward to their opinion. 
Thank you for sharing this with the Forum

Ahmed

-----Original Message-----
From: openheart-l-bounces at lists.hsforum.com
[mailto:openheart-l-bounces at lists.hsforum.com] On Behalf Of Donald Ross
Sent: Tuesday, July 17, 2007 3:02 AM
To: OpenHeart-L at lists.hsforum.com
Subject: Re: [HSF] Post-op arrest

Here is a change from rings:
82 yr. male had moderate infarct after his hip was pinned
Angio showed blocked everything and 40%EF
10 days post infarct prophylactic opcab X 2, rima to lad, lima to om
6 days post op, VT arrest in ward.
Angio shows patent rima to lad but "band" stenosis of lima to om just  
proximal to anastamosis ( looks bad  but rapid filling of om from lima.)
For some reason card doesn't want to pop stenosis with balloon.  
( Says ima too convoluted but I bet he would have done it if patient  
was private)
Questions:
1. Is VT due to stenosed graft or recent infarct?
2. Could the stenosis have been diagnosed by flow probe at operation?
3. What should I do now?

Don

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