[HSF] Another on vs off pump question, dilatation of IMA......

[Mitch Lirtzman]

John, I would respectfully disagree with part of the last posting. As one 
of the "wrappers and extraluminal injectors", in well over two decades, 
dark blood has never come out of the LIMA at the time of unclamping for 
grafting. I'm one of the leave-it-on-the-pedicle guys with accompanying 
veins. As stated, I don't skeletonize and have never had problems with 
graft length. My guess is that the vasa vasorum remain intact...or whatever 
circulation others have postulated, and the vessel remains a living organ. 
BRB across the table.
Mitch LirtzmanAt 08:45 PM 6/6/2007, you wrote:
>Don, you and others have said that you clamp and divide the IMA and lay it
>aside until time for the anastomosis, some with it wrapped in a sponge 
>soaked
>with papaverine and/or verapamil, some after injecting the same drugs into 
>the
>  lumen, and later found the IMA to be plump and pulsating. Perhaps there is
>another explanation. When you open the IMA after it has been clamped for 
>some
>time, the blood in the lumen is dark, desaturated, meaning that the oxygen
>has  been extracted, which must mean that the vessel wall has been ischemic.
>Could it  be that when the smooth muscle cells become ischemic, they lose 
>there
>capacity  to contract and the vessel wall relaxes and dilates and the drugs
>have nothing  to do with it? John Flege
>
>
>
>************************************** See what's free at http://www.aol.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 and
>disclaimers posted at:
>http://www.hsforum.com/listdisclaim
>-----------------------------------------