[HSF] Full metal jacket

[Donald Ross]

Same as any other graft: not too long, not too short but just right.  
( Goldilocks technique)
BTW skeletonised arteries are the most forgiving and preferred by  
Goldilocks and others.
Don
Is a southern cross and angry Texan or the progeny of him and his  
domestic help?
On 19/12/2007, at 8:56 AM, Zhandong Zhou wrote:

> Dr. Asai,
>
> How do you avoid kinking in sequential grafts.
>
> Z Zhou
>
> ----- Original Message -----
> From: "Tohru Asai" <toruasai at belle.shiga-med.ac.jp>
> To: <OpenHeart-L at lists.hsforum.com>
> Sent: Saturday, December 15, 2007 7:56 AM
> Subject: Re: [HSF] Full metal jacket
>
>
>> Nasser
>> Thanks for your compliment. Since I am an originator of the  
>> thread, I am
>> resposible to show the outcome.
>>
>> At the operation, since she was diabetic and circumflex was fairly  
>> large
>> with not critically stenotic and good native coronary flow, I  
>> decided not to
>> use arterial conduit for cx. Other target vessels were all 1.0 mm  
>> to less
>> than 1.5 mm at most. My strategy was to pick up these with sequential
>> technique and arterial graft usage. Arterial graft has ability to  
>> adjust its
>> luminal size to distal vessels. So we rarely see thrombosed  
>> occlusion in
>> early phase like saphenous vein.
>>
>> I do isolated CABG in mostly off-pump fashion and did it. But as  
>> Dr.Zhou
>> suggested, On-pump cabg may be especially preferred for this kind  
>> of thin
>> target as long as bleeding due to clopidogrel is not a concern.
>>
>> I check all graft flows in OR with transite time flowmeter. I  
>> cannot find
>> the operating record now, but I remember good diastolic augumented  
>> flow in
>> all three conduits. Heparin was reversed half dose. No significant  
>> bleeding
>> was observed.
>>
>> Lately the cardiologist, who took over the previous man,  
>> thankfully sent
>> CD-ROM of postop angiograms. I made a few pictures from it and  
>> attach to
>> this mail.
>> --
>> Tohru Asai
>>
>
>
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