[HSF] Left main from RCA

[Tea Acuff]

What is the age of the patient?

tea



----- Original Message ----
From: "zzhoumd at pol.net" <zzhoumd at pol.net>
To: OpenHeart-L at lists.hsforum.com
Sent: Sunday, April 27, 2008 11:40:33 PM
Subject: [HSF] Left main from RCA


I have a patient admitted for chest pain. Further work up show LM from ostium RCA and travel between Aorta and PA, (common ostium on CT angio) there is no conscense in the literature.

Option 1.
Reimplant LM to left siuns only. If intra mural, then unroof it without damaging the aortic valve. 

Option 2
Mini invasive LIMA to LAD, there are not much compression in resting, the concern is LIMA may close from competitive flow.

Option 3
Reimplant LM to the left sinus and graft LAD with a arterial graft in case LM kinks etc.. Bigger operation, but safer approach.

Any suggestions!

Z Zhou

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