[HSF] Full metal jacket

[Tea Acuff]

Instead of an end to end or end to side for inflow of two arterial conduits, sew a side to side giving three distals like a pitch fork with the Lima in situ for inflow.


tea


----- Original Message ----
From: Prasanna Simha M <prasannasimha at gmail.com>
To: OpenHeart-L at lists.hsforum.com
Sent: Friday, January 4, 2008 8:07:41 PM
Subject: Re: [HSF] Full metal jacket

What do you mean by U ? A hammock type of graft like a RIMA LIMA with an
interconnecting radial - like a hammock ? or just the same graft winding on
itself like a U ?

Prasanna

On Jan 5, 2008 5:18 AM, Tea Acuff <tacuff at swbell.net> wrote:

> I follow Tohru's style more although I don't have number rules and prefer
> to take a conduit to one "area" of the heart. I use more "multiple end to
> sides" by U graft and what i should perhaps call saphenous sequential "T"
> grafts(by using the stump of a branch as a side.
>
> I still think that a large portion of patients have moderate coronary
> stenosis in distributions that may also need consideration at the time of
> CABG.
>
> What if anything does a U due to your model, Prasanna, since there is
> still a distal after the U?
>
> tea
>
>
>
> ----- Original Message ----
> From: Tohru Asai <toruasai at belle.shiga-med.ac.jp>
> To: OpenHeart-L at lists.hsforum.com
> Sent: Thursday, January 3, 2008 8:56:02 AM
> Subject: Re: [HSF] Full metal jacket
>
> Dear Zhandong
> Don has already answered his strategy. But I would put my thought as
> well.Hope it helps.
>
> > How to you make the incision on the vein graft?.
> longitudinal
>
> > Do you do anything different if the vein is small but do not have
> > enough vein.
> No. Vein is almost always larger than artery, so I don't care. But if its
> quality is poor,I will harvest other arterial conduit.
>
> > How many maximal sequential anastomosis you will do?
> As far as its size and course look fine, max 4 for SVG, Max 3 for LIMA,
> Max
> 3 for GEA.
>
> > Do you
> > believe sequential is better than single?
> It depends. Single vein to thin target with poor run-off will not survive
> in
> long term, I guess. But we don't know real data.
>
> > When you do LIMA to Diag and LAD,
> > how do you make incision on the LIMA.
> Longitudinal. Lately I do RIMA to LAD, then LIMA to Diag and OM more
> often,
> give a little more respect to LAD ( deserve for single IMA).
>
> > is diamond anastomosis better?
> I use "diamond" or "parallel"(in-line by Don), depending on the more
> natural
> angle between the conduit and the side-to-side target site. And in thin
> arterial grafts, I generally avoid diamond anastomosis.and use parallel
> anastomosis often. In diamond, I make incision on arterial (or vein) graft
> no more than 1/3 of its circumference in order to avoid seagull deformity.
> In most cases, I usually use diamond for SVG, GEA, RA and some IMA with
> care
> taken for reasons mentioned above. On the contrary, I generously use
> "parallel" anastomosis quite often when the angle is OK.
> --
> 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
> -----------------------------------------
>



-- 
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
-----------------------------------------