[HSF] Another on vs off pump question......

[Tohru Asai]

Michael

What is "lytics"? Thrombolytics like TPA?
I personally do not agree with Ani. Your patient clearly has LV dysfunction
with significant large LAD territory. Most cases have some hibernated
myocardium to be saved by bypass and improve LV function.

I am just wondering whether it is common to have PET study to evaluate
viability of myocardium in such cases in US?

Another questions: Are there any severe lung diease like advanced emphysema
or fibrosis?

Without watching cath film, I can not be certain. But I would "cool down"
for a month,find inducible ischemia and/or viable myocardium, then accept
for bypass surgery maybe with excisional biopsy of lung mass, if respiratory
med guys agree with me. If closing device is available and reliable, no need
to open RA during OPCAB.
-- 
Tohru Asai
Shiga University of Medical Science
Otsu, Japan





> Indications for surgery - proximal high grade LAD lesion and a huge infarct
> salvaged by lytics.
> 
> -michael