[HSF] Occluded SVC

[Prasanna Simha M]

Ah !! I have to do that yearly when a newly "passed" MCh graduate dose his
first  few ASD's or any other open heart independently. Other times it is an
innominate artery injury while trying to dissect the suprasternal notch.
History repeats itself regularly. (Not that this cannot happen to
consultatnts as statistics do catch up with numbers!!)
Incidentally for the neophytes on the list remember that if direct suture
cannot be done /difficult or impossible open the RA and suture the tear from
within. Vacuum assist works well and you can also use an cuffed endotracheal
tube as the IVC cannula if vacuum assist is not available .
Prasanna

On Feb 1, 2008 7:26 PM, Shahid Mahmud Malik <smmalik at brain.net.pk> wrote:

> Hal,
> I had a similar situation whilst doing a MVR for severe mitral stenosis
> only
> last week in a frail lady.The tape snare when removed from IVC unwieled a
> tear in the back of IVC as blood continued  to well up.I must have caused
> a
> tear passing the instrument behind the ivc prior to the tape snare.Briefly
> on low flows,I stitched the posterior pericardium to the ivc medially and
> right pleura laterally.Bleeding stopped and so far no problems.If the
> problem with your patient does not go away with time ,you may consider
> Bovine tube graft among other solutions.
> Shahid Malik
> ----- Original Message -----
> From: <Hgrmd at aol.com>
> To: <OpenHeart-L at lists.hsforum.com>
> Sent: Friday, February 01, 2008 6:41 AM
> Subject: Re: [HSF] Occluded SVC
>
>
> > Nasser,
> >  Your thoughts are probably where I'm headed.  Thanks.
> >
> > Hal
> >
> >
> >
> > **************Start the year off right.  Easy ways to stay in shape.
> > http://body.aol.com/fitness/winter-exercise?NCID=aolcmp00300000002489
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-- 
Prasanna Simha M