[HSF] radial artery-vein patch

[zzhoumd at pol.net]

Don,

Thank you very much. I am doing MIDCAB for complex LAD and Diag disease or LAD+Intermediate disease with robotic assisted LIMA or BIMA take down.

I have tried sequential LIMA, BIMA and T graft with LIMA and radial. In order to do it through small incision, sequential is a little difficult as the anastamosis is not at same level. T graft with radial artery is a little easier.
 
Any comments?

Zhandong Zhou


Sent via BlackBerry by AT&T

-----Original Message-----
From: Donald Ross <donross at bigpond.com>

Date: Wed, 5 Mar 2008 08:55:12 
To:OpenHeart-L at lists.hsforum.com
Subject: Re: [HSF] radial artery-vein patch


Z Z,
I will send you the sketch and details directly to you as it has been  
posted on the HSF previously.
Don.
On 05/03/2008, at 12:29 AM, zzhoumd at pol.net wrote:

>
> Don,
>
> Could you describe the way that you do the radial to IMA anastamosis?
>
> Z Zhou
>
> Sent via BlackBerry by AT&T
>
> -----Original Message-----
> From: Donald Ross <donross at bigpond.com>
>
> Date: Tue, 4 Mar 2008 15:56:23
> To:OpenHeart-L at lists.hsforum.com
> Subject: Re: [HSF] radial artery-vein patch
>
>
> John,
> A crappy ima is a contraindication but this is very unusual in my
> experience. Perhaps because they are skeletonised and the extra
> length puts the T graft more proximal. Even when the ima dissects it
> is usually the distal third so it can be still used as a composite
> with the radial.
> Low EF and large hearts are actually an indication because you get
> all that extra radial length to play with.
> If there is LM or the patient is unstable I add to the inflow by
> using both imas
> Don
>
> On 04/03/2008, at 2:03 PM, john pj wrote:
>
>> Dr Don,
>>
>>   Do you think there are any conditions where one has to avoid
>> LIMA T/Ygrafts.
>>
>>   I have seen some surgeons avoiding T grafts  in patients with
>> small LIMA, low EF or large hearts.
>>
>> Hgrmd at aol.com wrote:
>>   Don,
>> The problem is getting through the operation with no conversion. Your
>> technique also illustrates a recurring theme of mine that for a
>> particular
>> procedure, better outcomes are associated with higher volume. When
>> I used to do
>> a significant number of standalone CABG's, better than half were
>> done off
>> pump. Now, if I get stuck with a standalone, I opt for the pump
>> unless the
>> aorta is really bad, or if there are only a couple of grafts to do.
>> Again,
>> thanks for sharing.
>>
>> Hal
>>
>>
>>
>> **************It's Tax Time! Get tips, forms, and advice on AOL
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