[HSF] Any One Had This Complication?

[Michael Firstenberg]

does that mean we can all go home and watch the grass grow?

-michael


On 4/27/08, Prasanna Simha M <prasannasimha at gmail.com> wrote:
>
> Learn something new everyday. This can fit the bill for today for
> highlighting this.
> Prasanna
>
> On Sun, Apr 27, 2008 at 7:20 PM, <Jbflegejr at aol.com> wrote:
>
> > Hal, we had a patient a few years ago, a severe vasculopath with
> extensive
> > PVD and aorto-iliac disease, on whom we did a MIDCAB with the LIMA and a
> > few
> > hours later she developed small bowel necrosis. We presumed that the
> LIMA
> > was a
> > critical source of blood supply to the abdominal viscera. I have an
> > angiogram
> > in my collection done for coronary disase  with both IMAs injected and
> > with
> > each injection there was extensive filling of the visceral vessels in
> the
> > upper
> > abdomen. I don't know what happened to that patient but  it was a good
> > illustration that the IMAs may contribute to the abdominal visceral
> blood
> > supply.
> > There was a report in one of the journals several years ago which showed
> > an
> > arteriogram of the IMA filling the arteries to a lower extremity. I had
> a
> > patient
> > who had the right IMA used for a coronary graft and developed a full
> > thickness
> > infarct of the abdominal wall in the right upper quadrant. A friend of
> > mine
> > from the west coast told me of a patient with severe peripheral vascular
> > disease
> > in whom he observed that the LIMA was unusually large and after its use
> as
> > a
> > coronary bypass had infarction of the small bowel. It seems pretty clear
> > that
> > there are some patients in whom the IMA is a critical source of blood
> > supply to
> > some important structure and when it seems unusually large one should ve
> > wary. It might be advisable to have IMA arteriograms to look for
> something
> > downstream that is dependant on the IMA for blood supply, particularly
> in
> > patients
> > who have severe peripheral vascular disease. John Flege
> >
> >
> >
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> > car
> > listings at AOL Autos.
> > (http://autos.aol.com/used?NCID=aolcmp00300000002851)
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>
> --
> Prasanna Simha M
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