AW: [HSF] Aortic dissection and CPR

[erdinç naseri]

Dear Dr.Golman,
whayt type of vascular graft do you use for axillary artery cannulation?
erdinc> To: OpenHeart-L at lists.hsforum.com> Subject: Re: AW: [HSF] Aortic dissection and CPR> From: GoldmanS at MLHS.ORG> Date: Mon, 17 Sep 2007 08:26:00 -0400> CC: > > We sew a graft to the axillary artery. No need to re canulate the aortic graft. Just staple the axillary graft at the end> > Scott Goldman MD> > Chairman > Department of Surgery> MLH> > -----Original Message-----> > From: "nand kejriwal" <nkkejriwal at gmail.com>> Subj: Re: AW: [HSF] Aortic dissection and CPR> Date: Mon Sep 17, 2007 6:01 am> Size: 5K> To: "OpenHeart-L at lists.hsforum.com" <OpenHeart-L at lists.hsforum.com>> > Erdinc > > In one of my cases, a vascular surgeon exposed the axillary for me. He > applied a side clamp to the artery. But instead of taking the side wall of > the artery, the transverse part of the jaw went behind the artey. Thereby, > it clamped the artery at two places. That way, the arteriotomy was brought > out of the depth of the wound. I found this an useful technique. > > nand > > On 9/16/07, erdinç naseri <enaseri at hotmail.com.tr> wrote: > > > > > > 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> Seldi > > nger 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> -----------------------------------------