[HSF] (no subject)

[hgrmd at aol.com]

Prasanna,

? I left the pacing wires undisturbed.? Their presence was the reason I didn't consider an endovascular approach or interposition of a tube graft.? I just used a big patch that was roughly twice the width of the gap left by the atriotomy.



Hal


-----Original Message-----
From: Prasanna Simha M <prasannasimha at gmail.com>
To: OpenHeart-L at lists.hsforum.com
Sent: Wed, 6 Feb 2008 6:31 am
Subject: Re: [HSF] (no subject)




And the pacing wires ?
Prasanna

On Feb 6, 2008 4:50 PM, <hgrmd at aol.com> wrote:

> 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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-- 
Prasanna Simha M
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