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

[Nasser F. Abou'Seada]

Thanks Mitch .... that was very kind of you ..... permission to use the
expression .... !

NFA


On 6/7/07, Mitch Lirtzman <drmitch at cox.net> wrote:
>
> Bright Red Blood. Immediately prior to anastomosis, I let the LIMA bleed
> freely..."BRB across the table"At 02:54 AM 6/7/2007, you wrote:
> >"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
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-- 
Nasser  F.  Abou'Seada,
MB,ChB,MD,FRCSEd,ChM,ChD C/Th,
FICS,FISCVS,FSSRCTS,FHMS,MESC