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

[Donald Ross]

Mitch,
How do you explain the fact that the ima veins are always thrombosed  
if you, unfortunately,  have an opportunity  to inspect  them next day?
Don

On 07/06/2007, at 2:54 PM, Mitch Lirtzman wrote:

> 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
>> -----------------------------------------
>
>
> _______________________________________________
> 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
> -----------------------------------------