[HSF] Re: [ccm-l] Image of the week Hemisternotomy

[Prasanna Simha M]

By doable I meant even my resident could do it and so is an index of
performability. Let me assure you that I tell every resident that they shall
not do it independently without me around to reiterate the necessity of
being first a safe surgeon . I have not done CABG's through this route but
people have done it.The fact that you can do an AVR also indicates that a
CABG is possible though I would have concern doing an OPCAB with this (I
think Don Ross does it he can give better tips on how to do them off pump)
In fact Dr Levinson and Dr Subramaniam do it trans xyphoid albeit in
selected cases. In all these cases I think it is more important to know when
to back off. For eg I do not do this in patients with a high PAPVC and in
tetralogy cases though one of my friends  in Kochi does Tetrads also through
this route. (absolute hemostasis of the upper part of the RVOT patch is
mandatory if using this approach.

On Thu, May 1, 2008 at 3:26 AM, Tea Acuff <tacuff at swbell.net> wrote:

> Please note that the aorta cannulation is "doeable". This is code for
> limited access. In many alternative incisions  the proximals (if used, Don)
> can be a bigger problem than the distals. An inadvertant problem with the
> arota can exact a high price. Ability to extend the incision is a real plus,
> but may not be worth the trip (to India). On the other hand having Prasanna
> be your surgeon may be worth some bumps in the road. He was not advertising
> for CAB, however, or so it seems..
>
> tea
>
>
>
> ----- Original Message ----
> From: Prasanna Simha M <prasannasimha at gmail.com>
> To: gabi ford <gabiford at hotmail.com>
> Cc: OpenHeart-L <openheart-l at hsforum.com>; "<ccm-l at ccm-l.org>" <
> ccm-l at ccm-l.org>
> Sent: Wednesday, April 30, 2008 12:29:03 PM
> Subject: [HSF] Re: [ccm-l] Image of the week Hemisternotomy
>
> swallow statins,exercise and diet instead of coming to get cut up !!
>
> Prasanna
>
> On Wed, Apr 30, 2008 at 10:57 PM, gabi ford <gabiford at hotmail.com> wrote:
>
> >
> > From: prasannasimha at gmail.com
> > >This is a view of the mitral valve during a hemisternotomy. I do not
> > think that the view is compromised. You can clearly see the subvalvar (I
> am
> > doing a combined chordoplasty (chordal shortening +neochordal
> construction )
> > of the AML chordae.
> >
> > Prasanna,
> >
> > Dare I say it?  AMAZING!!!!!  :)
> >
> > How do we get together when I need my bypass?
> > Your OR or mine?
> >
> > Thanks for the pic and explanation.  As always, impressive.
> >
> > Gabi, RN
>
>
>
>
> --
> Prasanna Simha M
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-- 
Prasanna Simha M