[HSF] Full metal jacket

[Prasanna Simha M]

Ah but the tips and tricks to determine the "just right length !!
Prasanna

On Jan 2, 2008 10:00 AM, Donald Ross <donross at bigpond.com> wrote:

> 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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-- 
Prasanna Simha M