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

[Donald Ross]

On 11/02/2008, at 1:49 AM, Michael Firstenberg wrote:

> Don,
>
> With your experience with radials - probably the largest I have  
> heard about
> - tell us what you do.
> 1) Do you soak it in anything once harvested?
flush with neat verapamil
> 2) Which direction of flow (I assume normal anatomic)
doesn't matter
> 3) Skeletonize?  Pedicle?
naked
> 4) Anything different on the anastamosis?
not really but like most of my grafts, side to side,
> 5) Post-operative management?  Ca++ blockers
never used them ( their use has never been validated)
>

>
>
> How do you select?
Don't use if Allen's and oxymiter test negative but accept patchy  
calcification.
>
>
> This may sound silly, but if you have such good results (which I am  
> not
> doubting) - does it not make sense to take it from the dominant hand?
I don't think so, I usually use non dominant however.
I have not used bilateral radials but it is okay to do so.
>
>
> -michael
>
> On 2/10/08, Hgrmd at aol.com <Hgrmd at aol.com> wrote:
>>
>> Don,
>> For once I agree with you.  It's a little distressing the way  the
>> majority
>> of us continue to rely on the saphenous vein, when arterial   
>> conduits are
>> available to those willing to work a little longer and  harder.   
>> My PA's
>> harvest
>> radials endoscopically through a stab wound at the  wrist.  We've  
>> yet to
>> see
>> an ischemic problem, because we carefully screen  pre- and
>> intraoperatively for
>> inadequate ulnar or palmar arch flow.  I  asked one of my junior
>> associates
>> why he basically only used the LIMA and  veins.  He sheepishly  
>> admitted
>> that
>> the increased time and effort was a  major factor in his decision.
>>
>> Hal
>>
>>
>>
>> **************Biggest Grammy Award surprises of all time on AOL  
>> Music.
>> (
>> http://music.aol.com/grammys/pictures/never-won-a-grammy? 
>> NCID=aolcmp003000000025
>> 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
> -----------------------------------------