[HSF] Apical saline insufflation

[prasannasimha]

I was trained to do both closed mitral and open mitrals with transapical 
manipulation of the Tubbs in the former and apical saline insufflation 
in the latter so it is a method  I am very conversant and comfortable. I 
am sure the same must be true for you too. That may add to my bias to 
use the transapical insufflation technique.
Prasanna
Nasser F. Abou'Seada wrote:
> Trans Ventircular Mitral Commissurotomy ..... I use Indian Tubbs ... 
> thought
> you'd tell me ...
>
> NFA
>
>
> On 6/4/07, prasannasimha <prasannasimha at gmail.com> wrote:
>>
>> What is TVMC ?
>> Prasanna
>>
>> Nasser F. Abou'Seada wrote:
>> > I quite agree with you Prasanna .... I do exactly the same .... and 
>> I do
>> > believe that apical insufflation is more accurate and assuring .....
>> > always
>> > easy to do .... amy be cause of TVMC??? ...
>> >
>> > NFA
>> >
>> >
>> > On 6/4/07, prasannasimha <prasannasimha at gmail.com> wrote:
>> >>
>> >> This is an old  picture of a repair done with a pericardial band. You
>> >> can see the excellent coaptation while the ventricle is insufflated
>> >> apically with the fluid egressing from the aortic root vent
>> >> demonstrating full filling and distention of the ventricle. Such a
>> >> result correlates very well with periop and postop TEE. Striving for
>> >> that makes decision making simple.
>> >> Somehow for me the transmitral insufflation  seems to be faulty at
>> times
>> >> as usually a "lip" can "unfurl" demonstrating a leak under 
>> pressure and
>> >> appears competent with plain transmitral insufflation.Lots of people
>> use
>> >> it successfully but it is not a good method in my hand. (Despite 
>> trying
>> >> to use the parrallel line of coaptationa and fill and press rules etc
>> >> etc. Could  people educate me on this further. I obviously am doing
>> >> something wrong with that method though I seem to have no problems 
>> with
>> >> the apical saline insufflation method. My colleague has become so
>> >> convinced with apical saline insufflation that he always asks me 
>> to do
>> >> it in addition (It is my habit to call some one else and always
>> >> demonstrate it to them also - sort of an internal quality control)
>> >> Prasanna
>> >>
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