[HSF] Full metal jacket

[Donald Ross]

On 03/01/2008, at 12:50 AM, zzhoumd at pol.net wrote:

>
> Sorry, I did not make the question clear.
>
> How to you make the incision on the vein graft,
longitudinal
> . Do you do anything different if the vein is small
no
> but do not have enough vein
get more
> . How many maximal sequential anastomosis you will do?
No limit ( 4 is  not infrequent )
> Do you believe sequential is better than single?
No, just more efficient of time and conduit
> When you do LIMA to Diag and LAD, how do you make incision on the  
> LIMA.
Same as above,
> is diamond anastomosis better?
No, just more convenient and and easier to measure and avoid kinks  
and saves precious arterial conduit when your graft crosses the  
target between 50 and 90 degrees.

Zho,
If you need more detailed technical information about my multiple  
arterial graft techniques talk to me off the forum by email or skype.
Cheers,
Don
>
> Thanks!
>
> Z
>
> Sent via BlackBerry by AT&T
>
> -----Original Message-----
> From: "Prasanna Simha M" <prasannasimha at gmail.com>
>
> Date: Wed, 2 Jan 2008 10:06:10
> To:OpenHeart-L at lists.hsforum.com
> Subject: Re: [HSF] Full metal jacket
>
>
> 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
>>>>
>>>
>>>
>>> -------------------------------------------------------------------- 
>>> --
>>> ----------
>>>
>>>
>>>> _______________________________________________
>>>> 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
>>> -----------------------------------------
>>
>> _______________________________________________
>> 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
>> -----------------------------------------
>>
>
>
>
> -- 
> Prasanna Simha M
> _______________________________________________
> 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
> -----------------------------------------