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

[Nasser F. Abou'Seada]

"BRB across the table"
What is BRB ?

NFA

On 6/6/07, Mitch Lirtzman <drmitch at cox.net> 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
> >
> >
> >
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-- 
Nasser  F.  Abou'Seada,
MB,ChB,MD,FRCSEd,ChM,ChD C/Th,
FICS,FISCVS,FSSRCTS,FHMS,MESC