Re: [HSF] Gengrenous bowels post uneventful CABG

[CSPassik at aol.com]

There was some old literature on concommitant intrarterial priscoline and 
salvage surgery.   Look up some old papers from Boley, SJ et al dating from the 
early 1980's. We used to follow this protocol and had what was stated at the 
time was the lowest mortality rate from embolic bowel infarction.   Basically, 
an angio catheter was placed by interventional radiology in the SMA and infused 
priscoline to offset the concomitant spasm that went along with the emboli.   
The patient was explored, the SMA embolectomized ,   and the bowel was 
reexamined at 24 hours if I remember correctly.   Sometimes some questinable bowel   
that initially looked non viable was saved.   I don't think many hospitals 
besides ours(Montefiore in NY)   did this and very few others seem to remember 
this work. Even if it is too late for this patient it might be worth thinking 
about when one of our poor patients gets this devastating complication.
Cary Passik


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