[HSF] (no subject)

[hgrmd at aol.com]

Dear Members,
? Two days ago, I reoperated on the gentleman with the stenotic and thrombosed SVC.? I'm glad I did.? I femorally cannulated and went on pump prior to splitting the chest (he was 3 weeks postop).? I only dissected the right atrium.? The adhesions were torture.? The tip of the femoral cannula was advanced only into the IVC.? No effort was made to control either cava.? The heart stayed warm and beating.? A right atriotomy was made and extended across the RA-SVC junction.? It was tightly stenotic.? A large amount of clot was retrieved with a 6mm Fogarty.? A large patch of bovine pericardium was placed.? The whole operation took less than 3 hours.? Yesterday, it was evident that his facial and forearm edema were markedly improved.? He's already on Lovenox and Coumadin.

Hal
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