AW: [HSF] Aortic dissection and CPR

[erdinç naseri]

Dear Dr. Batellini,
I do it as per your description .With a side clamp it's more difficult in the depth of subclavicular area .
erdinc
> From: battr at medizin.uni-leipzig.de> To: OpenHeart-L at lists.hsforum.com> Subject: AW: [HSF] Aortic dissection and CPR> Date: Sat, 15 Sep 2007 15:24:47 +0200> CC: > > Erdinc,> a comment: if you anastomose a prosthesis in the axillary artery for pump> cannulation, do not clamp it with a lateral clamp, do it with two femoral> clamps separately , they are less traumatic. I saw someone clamping it> laterally in a type B "debranching" and the artery was dissected.> Roberto> > -----Ursprüngliche Nachricht-----> Von: openheart-l-bounces at lists.hsforum.com> [mailto:openheart-l-bounces at lists.hsforum.com] Im Auftrag von erdinç naseri> Gesendet: Samstag, 15. September 2007 02:46> An: openheart-l at lists.hsforum.com> Betreff: RE: [HSF] Aortic dissection and CPR> > > Ani,> I said theoreticaly it may lead to malperfusion. In most of our acute> dissection cases there is such an anatomical mess in the ascending aorta> which I don't dare to do it.Of course it would be much safer if you use> Seldinger technique which is unavailable to me.> erdinc> PS: Having your and others assurance I will use it nesxt time it becomes> neccessary.> From: anianyanwu at hotmail.com> To:> openheart-l at lists.hsforum.com> Subject: RE: [HSF] Aortic dissection and CPR>> Date: Fri, 14 Sep 2007 16:12:45 +0000> > Erdinc> > I would not go as far as> saying direct aortic cannulation in type A dissection must be used only in> desperate cases. Maybe you should try it one day and you might change your> mind. Several surgeons use this approach routinely and I doubt they pray> throughout the case. > > See for example:> > Cartier (Montreal) ICTVS 2003> 178-180 (they use a guide wire, pressure measurement and echo to ensure> placement in true lumen> > Yamada (Kyoto) ICVTS 2003 175-77 (Also use> seldinger with echo guidance used in 12 of 14 patients, they argue it is> simpler and quicker and the most certain way to cannulate the true lumen)> >> Jegaden (lyon) JTCVS 2007 134:547-8 (used in 15 of 20 cases)> > Kron> (virginia) JTCVS 2007 133:428-34 (used in 24 cases - lower> mortality with central vs peripheral cannulation)> > Jakob (essen) JTCVS> 134 244-5 (8 cases - exanguination, aortic transection and direct> cannulation of lumen)> > Haverich (hannover) JTCVS2003 125:952-3 (14 cases,> no attempt to determine true from false lumen).> > There are several other> recent reports of success with this technique since the first case report> from the genoa group in 1998 so it appears more and more surgeons are> adopting this approach.> > We should not be too quick to condemn alternative> and unconventional techniques without trying them or examining the data;> else we may lose potential opportunities to improve on what we do. In fact> it is arguable that direct aortic cannulation - either directly or via the> apex, as described by Flege and others - is the only way one can be certain> that the true lumen is being perfused. > > Ani> > > > > From:> enaseri at hotmail.com.tr> To: openheart-l at lists.hsforum.com> Subject: RE:> [HSF] Aortic dissection and CPR> Date: Fri, > 14 Sep 2007 11:07:42 +0000> > > Direct cannulation of the aorta in> dissection cases can at least theoreticaly lead to malperfusion in those> cases without any re-entry tear.It must be used only in desperate cases with> no other choice ( andpray throughout the case).> erdinc >> _______________________________________________> OpenHeart-L mailing list> >> Send postings to:> OpenHeart-L at lists.hsforum.com> > To UNSUBSCRIBE, to> CHANGE email address, or to view archives:>> http://mmp.cjp.com/mailman/listinfo/openheart-l> > All messages transmitted> by the OpenHeart-L are subject to the policies and > disclaimers posted at:>> http://www.hsforum.com/listdisclaim>> ----------------------------------------->> _________________________________________________________________> Celeb> spotting – Play CelebMashup and win cool prizes>> https://www.celebmashup.com_______________________________________________>> OpenHeart-L mailing list> > Send postings to:>> OpenHeart-L at lists.hsforum.com> > To UNSUBSCR> IBE, to CHANGE email address, or to view archives:>> http://mmp.cjp.com/mailman/listinfo/openheart-l> > All messages transmitted> by the OpenHeart-L are subject to the policies and > disclaimers posted at:>> http://www.hsforum.com/listdisclaim>> -----------------------------------------> _______________________________________________> OpenHeart-L mailing list> > Send postings to:> OpenHeart-L at lists.hsforum.com> > To UNSUBSCRIBE, to CHANGE email address, or to view archives:> http://mmp.cjp.com/mailman/listinfo/openheart-l> > All messages transmitted by the OpenHeart-L are subject to the policies and > disclaimers posted at:> http://www.hsforum.com/listdisclaim> -----------------------------------------> > _______________________________________________> OpenHeart-L mailing list> > Send postings to:> OpenHeart-L at lists.hsforum.com> > To UNSUBSCRIBE, to CHANGE email address, or to view archives:> http://mmp.cjp.com/mailman/listinfo/openheart-l> > All messages transmitted by the OpenHeart-L are subject to the policies and > disclaimers posted at:> http://www.hsforum.com/listdisclaim> -----------------------------------------