[HSF] ima dilatation

[erdinç naseri]

Don,
Have been using intraluminal injection of papaverine throughout whole my surgical carrier:
1.good augmentation og-f the graft.
2.no dissection unless a previously unnoticed one is present.
erdinc> From: donross at bigpond.com> Subject: Re: [HSF] ima dilatation > Date: Mon, 30 Jul 2007 17:19:19 +1000> To: OpenHeart-L at lists.hsforum.com> CC: > > Mark,> I think my unfortunate dissections with retrograde ima injection may > have been related to the fine olive tipped needle from DLP which I > used . I think it was "too sharp" and hopefully the 22G angiocath > will be safer.> It must have been at least 10 years since I abandoned intra-luminal > injection, so really the advantages can't be all that great.> Cheers,> Don> On 29/07/2007, at 2:13 PM, Mark Levinson wrote:> > >> > On Jul 22, 2007, at 1:05 AM, Donald Ross wrote:> >> >> Tohru,> >> I appreciate the details of how you sex up the internal mammary.> >> I hope, somewhat different from the technique you use for the > >> external variety.> >>> >> I like your technique for intra-luminal injection and will start > >> doing it again to avoid the advential band which was not > >> detected because the ima was not fully dilated.> >>> >> BTW I use verapamil undiluted> >>> >>>> >> > Don:> >> > Skeletonization and then intraluminal injection allows you to > > identify these bands (if any are left after skeletonized harvest) > > and they are snipped with> > the fine coronary scissors before grafting. I use the same > > intraluminal injection as Tohru Asai (only with VG + Regitine) and > > this confirms that the> > graft has high flow, no dissections and no strictures before I > > gamble the fate of the patient on it.> >> > I think distal injection can be done safely, and the response is > > immediate so you can then plan the case knowing the graft is OK or > > not.> >> > If the IMA dissects with retrograde injection, it is most likely > > that a flap already exists and you just made it more obvious. > > Better to know before> > grafting than to find out in the ICU. I find that local > > dissections can be hidden under the pedicle in non-skeletonized > > conduits.> >> > However, I have watched video of your dissection technique, and I > > know that you take the vein, and not much is left...> >> >> > Mark> >> > Mark M. Levinson, MD> > Founder, Editor-in-Chief,> > The Heart Surgery Forum> > WWW: <http://www.hsforum.com>> > Email: <mmLevinson at hsforum.com>> >> >> >> > _______________________________________________> > 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 anddisclaimers posted at:> > http://www.hsforum.com/listdisclaim> > -----------------------------------------> _______________________________________________> 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> -----------------------------------------