[HSF] Pseudoaneurysm at SVG Top end

[erdinç naseri]

prasanna,
how do you put PA vent thru Rthoracotomy?
erdinc> Date: Fri, 7 Mar 2008 06:49:42 +0530> From: prasannasimha at gmail.com> To: OpenHeart-L at lists.hsforum.com> Subject: Re: [HSF] Pseudoaneurysm at SVG Top end> CC: > > This is what I have done for eroding aneurysms of the aorta which are> eroding and popping through the sternum and would present a similar> set of problems.> Femoral or better still axillary cannulation.fem/axilary - fem vein> bypass., Foleys balloon ready.If you have a heart port endovent ,vent> via the endovent or else a limited right anterior thoracotomy to put a> PA vent.Open sternum after cooling with TEE /TTE monitoring of> distention. have a GPI drip running and K kept above 4.0 (hypothermia> causes K to fall) that you can cool well down with the heart beating.> Ice pack the head. If there is bleeding you can go on low flows to> complete the sternotomy and dissect the pseudoaneurysm and a Foleys> can be pushed in if there is no clot.Grams stain of tissue to rule out> infection. Debridement of edges till healthy aorta and patch the> aorta.> The pseudoaneurysmal part can be excised and a vein can be put from> that to the old graft if OK.> Prasanna> > On Fri, Mar 7, 2008 at 4:05 AM, <wftjrtyler at aol.com> wrote:> > Fellows,> >> > Need advice on the following case:> >> > 64 year old lady post op OPCAB x 2 (LIMA-LAD, SVG-PDA/RCA) Nov. '07.> > Proximal performed with Guidant Heart String. She now presents with chest wall> > pain. CT scan of chest shows 7 x 8 cm Pseudoaneurysm at SVG Proximal> > Anastomotic Site. Appreciate recommendations regarding cannulation approach, repair,> > etc.> >> > Thanks,> >> >> > Bill Turner> >> >> >> > **************It's Tax Time! Get tips, forms, and advice on AOL Money &> > Finance. (http://money.aol.com/tax?NCID=aolprf00030000000001)> > _______________________________________________> > 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> -----------------------------------------