[HSF] Does the LIMA really string?

[David Harris]

Many thanks again Prasanna for the picture transfer.
Tha patient had a 60 to 70% proximal LAD lesion. The
LAD was relatively larger than the LIMA. After
injecting (I never do!) the LIMA and clipping it
distally , the flow was not great, and it did not
dilate well. There was a prominant spurt of blood from
the LAD after opening it. I left the bulldog on the
LIMA (proximally) for a while after completing the
graft, and this caused it to dilate nicely. Before
closing the chest the graft looked fine.
I am sure that bidirectional flow in these grafts keep
them open, until the stenosis progresses, and the LIMA
dominates. It would be nice to know exactly how much,
which direction, and relatively during which part of
the cardiac cycle.

David Harris
--- Donald Ross <donross at bigpond.com> wrote:

> Thanks for the picture transfer Prasanna.
> David,
> Did you know the status of the LM stenosis at the
> time of the CT?
> 
> Also, does anyone have any experience with the
> assessment of ima  
> patency using percutaneous doppler or know of an
> authoritative  
> reference?
> 
> Don
> On 01/06/2007, at 11:27 AM, prasannasimha wrote:
> 
> > This is a picture sent by David Harris of a case
> with a small LIMA  
> > and left main 50 % (If I remember right). No
> string !!
> > David will complete the description.
> > Prasanna
> > <LIMA to LAD nonstring eml.jpg>
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Dr. David G. Harris, FCS, MMED,
Cardiothoracic Surgeon        
Suite 207                                
Kuils River Private Hospital,        
PO Box 1200, Kuils River, 7579, Cape Town, South Africa.            
Tel +27-21-9006411             
Fax +27-21-9006412      Mobile +27-83-3309587