[HSF] Any One Had This Complication?

[Tea Acuff]

there is always the chance that at some point the things won't fit together any more and then you will have to go home and reorganize (rethink) them...while you watch or mow the grass
tea



----- Original Message ----
From: Michael Firstenberg <msfirst at gmail.com>
To: OpenHeart-L at lists.hsforum.com
Sent: Sunday, April 27, 2008 12:02:13 PM
Subject: Re: [HSF] Any One Had This Complication?

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
> >
> >
> >
> > **************Need a new ride? Check out the largest site for U.S. used
> > car
> > listings at AOL Autos.
> > (http://autos.aol.com/used?NCID=aolcmp00300000002851)
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>
> --
> Prasanna Simha M
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