[HSF] PCI Vs CABG - not all about evidence

[Ani Anyanwu]

> I agree with Ed to choose SVG to RCA. RIMA mostly reaches distal RCA rarely> to PDA. 
> -- > Tohru Asai
 
My limited experience though is that the skeletonised RIMA almost always reaches the proximal PDA - whether that is the right conduit for this target is of course a different debate but it surely does reach. I have used the skeletonized RIMA to PDA on several occasions in patients with single vessel RCA disease undergoing concurrent cardiac operations.
 
Ani



> Date: Thu, 3 Jan 2008 23:05:54 +0900> Subject: Re: [HSF] PCI Vs CABG - not all about evidence> From: toruasai at belle.shiga-med.ac.jp> To: OpenHeart-L at lists.hsforum.com> CC: > > > I would choose LIMA to LAD and good quality SVG to RCA. I am> > worried about recurrent disease or some other process requiring re-> > sternotomy. In my hands, re-entry is easier with SVG to RCA than RIMA.> I agree with Ed to choose SVG to RCA. RIMA mostly reaches distal RCA rarely> to PDA. Thin distal end of RIMA is known to prone to be spastic sometime and> I don't like to put RIMA into distal RCA, often thickened walled vessel even> though angiographic lumnal size is adequate. If RCA is large, somehow> ectatic,and with only 70% stenosis, I would never put RIMA. Radial and GEA> also are not promising. Good vein to proximal PDA is my answer,> However I don't understand what problem will occur when RIMA connected to> RCA. It usually off the center. We can make RIMA off sternum.> -- > 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> -----------------------------------------
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