AW: [HSF] Twisting of Vein grafts

[Tea Acuff]

Use a doppler probe and listen to the graft for diastolic augmentation. It is not a number but a sign of run off.
tea


----- Original Message ----
From: Dr. Roberto Battellini <battr at medizin.uni-leipzig.de>
To: OpenHeart-L at lists.hsforum.com
Sent: Wednesday, March 7, 2007 5:04:14 PM
Subject: AW: [HSF] Twisting of Vein grafts


He said they have no Flowmeters!
He needs another answer, such as : do double mammaries, etc.
Roberto

-----Ursprüngliche Nachricht-----
Von: openheart-l-bounces at lists.hsforum.com
[mailto:openheart-l-bounces at lists.hsforum.com] Im Auftrag von Ben Bidstrup
Gesendet: Mittwoch, 7. März 2007 23:26
An: OpenHeart-L at lists.hsforum.com
Betreff: RE: [HSF] Twisting of Vein grafts

Very similar to the cardiologists having to ensure proper stent 
deployment with IVUS . So you can lean on the management.

>This can be avoided by measuring flows in the grafts or performing other
>type of quality control of the anastomoses prior to closure.
>
>Tomas
>
>-----Original Message-----
>From: openheart-l-bounces at lists.hsforum.com
>[mailto:openheart-l-bounces at lists.hsforum.com] On Behalf Of David Harris
>Sent: Wednesday, March 07, 2007 4:52 PM
>To: OpenHeart-L at lists.hsforum.com
>Subject: Re: [HSF] Twisting of Vein grafts
>
>I`m sure your cardiologist was thrilled, and
>considered stenting the next 20 cases :-) The best way
>to avoid this is to use double internal thoracic
>arteries for all patients, followed by radial as next
>choice, and using veins only where a thoracic cannot
>be used, and where a radial should be avoided because
>the stenosis is less than 60 to 70 %.
>
>Then we will also be in a better position to criticise
>cardiologists for overuse of stents
>
>
>--- rashid akther <rashid_akther at yahoo.co.in> wrote:
>
>> 
>>    We had   an unexpected   twisting and thrombosis
>>  of an OM vein graft which was noted   at
>>  rexploration for bleeding. We   have checked the lie
>>  of the vein graft   with heart in the lifted up
>>  position   and thought that twist   should have
>>  happened with changed  lie of the graft after
>>  dropping it.
>>   
>>  How to prevent   twisting   of vein grafts?[ We do
>>  not have flow probes to check the flow at the end of
>>  the procedure]
>> 
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>
>
>Dr. David G. Harris, FCS, MMED,
>Cardiothoracic Surgeon       
>Suite A2                               
>Tygerberg Hospital, 7505      
>Cape Town, South Africa.           
>Tel +27-21-9762347            
>Fax +27-21-9761157      Mobile +27-83-3309587
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-- 
Ben Bidstrup FRACS FRCSEd FEBCTS
Consultant Cardiothoracic Surgeon
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