[HSF] RE: Timing AVR/Coarctation repair

[Nasser F. Abou'Seada]

1- extra-natomical conduit bypass of the COARC through let thoracotomy,
Tangential clamp only of the aorta
2- AVR, same sitting, as through median sternotomy -my approach-

NFA

On 5/8/07, Antonio Laudito <laudito at musc.edu> wrote:
>
> Dear Members,
>
> A 50 yr old pt show up to your office with a dx of severe AS (EF OK, no
> CAD)and severe coarctation ( MRI with a few mm lumen). What would be
> your recomended surgical strategy?
> Thanks
> Antonio Laudito,MD
> >>> hgrmd at aol.com 07/05/07 16:25 >>>
> Dear Members,
> One of the senior members of my group and I were discussing the merits
> of using a PA vent versus an LA vent when encountering LV distension
> just after releasing the clamp.  Typically, it is due to mild or
> moderate AI.  Personally, I prefer using the main PA as the vent site.
> It's quick and easy, and I've always found that it decompressed the LV
> nicely.  In contrast, my friend says that it's better to use an LV vent
> so as to avoid pulling all of that blood through the capillary beds and
> risking acute pulmonary injury.  I've never read that, and it sounds
> like theoretical crap to me.  What do you think?
> Hal
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-- 
Nasser  F.  Abou'Seada,
MB,ChB,MD,FRCSEd,ChM,ChD C/Th,
FICS,FISCVS,FSSRCTS,FHMS,MESC