AW: AW: [HSF] aortic root reimplantation and Rv dysfx

[erdinç naseri]

>Dear Robertto,
> as an old surgeon, I remember the old times ort he "ice era", we covered the> heart with ice and the protection of the right heart was excellent. Also I> remember being 10 days at Stanford in 1982: Dr Shumway did not perform> cardioplegia, but made a bath of very cold saline the whole time, in the> pericardial sac, with excellent clinical results. I saw him personally.Add> this to your armamentarium for those cases.
 
1.In retrospect I even thought that I should have cooled down to 18 degrees and used a lot of 4 degree saline .Must it be cold slush or does  cold  saline suffice?
> Considering retrograde cardioplegia, if you have a two stage cannula you are> not 100% sure that the cannula is just exactly at the coronary sinus ostium,> but if you use double cannulation, then yes. Did you begin with double stage> and changed?
 
2.I started with 2 stage single cannulae  as is the routine for aortic cases ( I didn't want to repair TR) and then converted to double venous cannulae.I check the tip of the CS cannulae and pay attention that it be at the very prx. partof the CS.
> And for Tric insuf only grade one I would not have considered it the cause> of the problem.> Was the core of the endarterectomy complete? Was the distal anastomosis on> the descending posterior?
 
3.I started arteriotomy at the last 2 cm of RCA but because of unsmooth tail I continued distally and finally ended  quiet far in PDA.
erdinc