[HSF] Dissection extending into carotids

[A]

Roberto:
Could you please re-post the photo Thanks 

Ahmed

-----Original Message-----
From: openheart-l-bounces at lists.hsforum.com
[mailto:openheart-l-bounces at lists.hsforum.com] On Behalf Of Dr. Roberto
Battellini
Sent: Tuesday, March 20, 2007 12:21 AM
To: OpenHeart-L at lists.hsforum.com
Subject: AW: [HSF] Dissection extending into carotids

This is the most important mail of the week, together with Erdinc´s case.

I have not the answer, but we had a similar case 2 weeks ago, the patient
had dissection of both carotids. The surgeon cannulated the axilary artery,
and cooled  to 18 degrees, but clamped the aorta before 18 degrees. The
patient died neurologically.
 My personal thoughts are that in these cases we should wait until the EEG
is a line or until 18 degrees and the cut one  carotid, and sew a prosthesis
and begin to perfuse throughit. And replace all the arteries separately,
looking that all the dissected tissue is resected , even if we need to open
the neck (I am also vascular surgeon and perform the carotids here)
I can send you a photo from an operation with this concept. Prasanna already
posted the photo last year.
Roberto

-----Ursprüngliche Nachricht-----
Von: openheart-l-bounces at lists.hsforum.com
[mailto:openheart-l-bounces at lists.hsforum.com] Im Auftrag von john pj
Gesendet: Montag, 19. März 2007 09:40
An: OpenHeart-L at lists.hsforum.com
Betreff: [HSF] Dissection extending into carotids

When aortic dissection extends in to carotids  how do we monitor adequacy of
cerebral flow while on bypass for the dissection repair? 
  How do we  manage if the flow is not restored at the end of surgery? 

 
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