[HSF] Abnormal LIMA

[Giuseppe Rescigno]

I would restudy the patient before hospital dismissal.


Giuseppe Rescigno M.D.
Cardiothoracic Surgeon

Lancisi Hospital
Torrette - Ancona
Italy


 
On Monday, October 01, 2007, at 04:51AM, "john pj" <john_pj15 at yahoo.com> wrote:
>2 days back we operated  a 54 yr old man for LT main stenosis with lesions in LAD and OM.The LIMA[2.5 mm in size] was harvested with out  any difficulty  and  had good pulsation and flow when divided. When we divided the distal end we noted that the  thick intima was telescoping beyond the remaining layers. When it was cut opened the intima was more opaue  and lacked the lustre of normal intima. The thickened  Intima was sliding against other layers as if they are separated. It was not like dissection. We did not see any localised atherosclerosis plaques .
>  .
>  We exised about 3 cm LIMA and there was no change in teh appearence . We went ahead with LIMA to LAD grafting takinkincare to incluse all the layers cautiously.We are watching the patient closely. We have low threshold to go back to replace it with a vein in case  of any problems in the LAD territory.
>   
>Any comments?
>       
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