[HSF] RCA osteal lesion-osteal reconstruction

[Tea Acuff]

This was the approach sans robot that Mark presented to the HSF dinner club this year at Hals place..

tea



----- Original Message ----
From: "zzhoumd at pol.net" <zzhoumd at pol.net>
To: OpenHeart-L at lists.hsforum.com
Sent: Sunday, April 27, 2008 11:19:22 PM
Subject: Re: [HSF] RCA osteal lesion-osteal reconstruction


Ed,

I have never seen or tried a subxyphiod approach. If you have any video or picture, let me know. 

I have done many pericardial windows with subxyphoid approach. How is the incision compared to pericardial window.

Thanks!

Z Zhou

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-----Original Message-----
From: DukeB60 at aol.com

Date: Sat, 26 Apr 2008 11:13:52 
To:OpenHeart-L at lists.hsforum.com
Subject: Re: [HSF] RCA osteal lesion-osteal reconstruction


Z,
    Have you looked into the subxyphoid  approach for this type of case after 
robotic IMA harvest?  The exposure is  better than you might expect and it is 
possible to avoid even partial sternotomy  or a thoracotomy all together.

Edward P. Raines, M.D.,  J.D.                                                
              Ed
BryanLGH  Cardiothoracic Surgery
BryanLGH Medical Center East 
1600 South 48th  Str.
Lincoln, Nebraska 68506
Office: 402-481-8430
Cell:  402-730-9242
Fax: 402-481-8429



In a message dated 4/26/2008 8:27:06 A.M. Central Daylight Time,  
zzhoumd at pol.net writes:


Hal,

I have been using Robot to take down the RIMA than  graft the RCA in case 
like this through a small low sternotomy. 

Z  Zhou



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-----Original  Message-----
From: Hgrmd at aol.com

Date: Sat, 26 Apr 2008 06:25:16  
To:OpenHeart-L at lists.hsforum.com
Subject: Re: [HSF] RCA osteal  lesion-osteal reconstruction


If the RCA lesion is all she has, then  PCI should be offered first.  If 
not, 
then medical  therapy.  If that fails, then consider surgery.  However, I  
can't recall the last time my group or I intervened for one  RCA.

Hal



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