AW: AW: [HSF] OPCAB

[Tea Acuff]

I would submit that even if the artery is open does not show it is important. Just that it ist (typo and German) open.
tea


----- Original Message ----
From: prasannasimha <prasannasimha at gmail.com>
To: OpenHeart-L at lists.hsforum.com
Sent: Wednesday, March 14, 2007 1:21:44 PM
Subject: Re: AW: AW: [HSF] OPCAB


Incidentally what was the reason for ST alterations and enzyme leak ?
Prasanna

Dr. Roberto Battellini wrote:
> Prasanna,
> I do every day a bypass in an artery of 1mm, and have many restudied and OK.
> In these cases I do all with 8/0, including veins with 8/0 in oldtimers.
> For example yesterday I did a RIMA to PDA, LIMA to LAD and radial to obtuse
> marginal +intermediate both 1 mm and Flow 16 ml/min, low.(CLP 60 min).
> During the night (already extubated and stable) had ST alterations in the
> posterior wall, got a recath (here we recath all the ST alterations + CK
> elevations) and it was all OK.
> May be I would not have recath on him, but I accept this decisions from the
> young´s as a quality control for my anastomoses.
>
> -----Ursprüngliche Nachricht-----
> Von: openheart-l-bounces at lists.hsforum.com
> [mailto:openheart-l-bounces at lists.hsforum.com] Im Auftrag von prasannasimha
> Gesendet: Mittwoch, 14. März 2007 14:20
> An: OpenHeart-L at lists.hsforum.com
> Betreff: Re: AW: [HSF] OPCAB
>
> But is a 1mm OM worth revascularizing ? that is a question that needs to 
> really be answered - the usual recommendation is to revascularize 
> vessels at least 1.5 mm as the smaller vessels are being revascularized 
> into a bed that would just have a high resistance and mostly occlude by 
> the time you sent the patient home.
> While I agree that LIMA to LAD is the ultimate determinant of "life" a 
> suddenly occluded RCA graft (if put pre PD ) can also be life 
> threatening post op. I prefer to always put the PD graft post crux as 
> far as possible both for patency (as demonstrated by the Cleveland 
> clinic data and also safety.)
> Prasanna
> Dr. Roberto Battellini wrote:
>   
>> Erdinc,
>> again, there is a good paper from Cleveland showing that complete
>> revascularization is better. All have the name of Blackstone in the
>>     
> authors
>   
>> list.
>> Roberto
>> -----Ursprüngliche Nachricht-----
>> Von: openheart-l-bounces at lists.hsforum.com
>> [mailto:openheart-l-bounces at lists.hsforum.com] Im Auftrag von erdinç
>>     
> naseri
>   
>> Gesendet: Dienstag, 13. März 2007 21:50
>> An: OpenHeart-L at lists.hsforum.com
>> Betreff: Re: [HSF] OPCAB
>>
>> Dear Dr.Harris,
>> Is there any prospective randomized large study to compare complete and 
>> incomplete revascularization?What is your average graft/ patient in OPCAB 
>> cases?If >1, then why?as medicine and cardiac surgery as a part is a
>>     
> branch 
>   
>> of science we have to follow its ru,es(statistics in  well planned
>>     
> studies) 
>   
>> and not rely on anecdotes.Finally, giving examples from cars and fighter 
>> airplanes may satisfy our egos  but would not shape the future of care of 
>> the cardiac patients.
>> erdinc
>>
>>
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