[HSF] Another Victory for the LAD Stent.....

[Donald Ross]

I also do quite a few of these cases which usually have an old  
fashioned vein to OM which has gone down but also occasionally , new  
native disease. All of course have had failed angioplasy. They are  
reliably tackled via a small lateral thorocotomy with a radial from  
aorta, opcab.
Don
On 10/02/2008, at 8:38 AM, Edward Bender wrote:

> If I remember correctly, there was crossover to redo CABG for  
> refractory
> symptoms in the presence of un-stentable vessels.  This has been my  
> limited
> experience, also.  The usual scenario is a patent LIMA to the LAD,  
> occluded
> native LCx and RCA, with ungrafted vessels, occluded grafts, or  
> severely and
> diffusely diseased grafts so that a filter wire would not be  
> protective of
> embolization. I usually have to do 2 or 3 of these types of cases a  
> year.
> The most distressing are the ones with severely diseased patent  
> grafts going
> to the OM branches.  I would bet most of these patients come out of  
> the OR
> with ST segment elevation.
>
> Ed Bender, MD
>
>
> On 2/9/08 2:51 PM, "Hgrmd at aol.com" <Hgrmd at aol.com> wrote:
>
>> Ani,
>>   To be honest, I didn't critically analyze the paper from CCF.    
>> They very
>> well could have done some arcane data massage to prove a point.    
>> However,
>> their conclusions basically support the policies of the surgeons  
>> in my  group
>> as
>> well as the referring cardiologists.  It's rare that we do a redo   
>> stand alone
>> CABG when there is a well functioning LIMA to the LAD.  For one   
>> thing, the
>> interventionalists can generally do enough PCI to get by.  If   
>> they can't, the
>> patient is usually treated medically.  Since I haven't done  a  
>> stand alone
>> CABG
>> so far this year, I can't speak authoritatively.   However, I do  
>> believe it's
>> rare that we reoperate when there is a good LIMA to  the LAD.
>>
>> Hal
>>
>>
>>
>> **************Biggest Grammy Award surprises of all time on AOL  
>> Music.
>> (http://music.aol.com/grammys/pictures/never-won-a-grammy? 
>> NCID=aolcmp003000000
>> 025
>> 48)
>> _______________________________________________
>> OpenHeart-L mailing list
>>
>> Send postings to:
>>  OpenHeart-L at lists.hsforum.com
>>
>> To UNSUBSCRIBE, to CHANGE email address, or to view archives:
>> http://mmp.cjp.com/mailman/listinfo/openheart-l
>>
>> All messages transmitted by the OpenHeart-L are subject to the  
>> policies and
>> disclaimers posted at:
>> http://www.hsforum.com/listdisclaim
>> -----------------------------------------
>
>
> _______________________________________________
> OpenHeart-L mailing list
>
> Send postings to:
>  OpenHeart-L at lists.hsforum.com
>
> To UNSUBSCRIBE, to CHANGE email address, or to view archives:
> http://mmp.cjp.com/mailman/listinfo/openheart-l
>
> All messages transmitted by the OpenHeart-L are subject to the  
> policies and
> disclaimers posted at:
> http://www.hsforum.com/listdisclaim
> -----------------------------------------