[HSF] RCA osteal lesion-osteal reconstruction

[wftjrtyler at aol.com]

Mark, in addition to your article HSF '05, what other links,sources do you recommend?   thanks, bill turner


-----Original Message-----
From: Mark Levinson <mmlevinson at hsforum.com>
To: OpenHeart-L at lists.hsforum.com
Sent: Thu, 1 May 2008 10:47 pm
Subject: Re: [HSF] RCA osteal lesion-osteal reconstruction


On Apr 29, 2008, at 12:01 AM, DukeB60 at aol.com wrote: 
 
> Z, 
> Check out the video on the Heart Surgery Forum website by Mark > Levinson. 
> He has some excellent photos and is a great resource for the > technique. If 
> you have the robot it greatly simplifies taking down one or both > IMA's, as 
> you well know. 
> 
> 
 
Subxiphoid OPCAB is safe if you understand the anatomy, technique, and add a few instruments 
to your tray. 
 
The key is using a double Rultract with a connecting bar to lift the lower sternum. The RIMA can 
be harvested in a standard manner, and OPCAB technique to the distal RCA is not too difficult. 
 
However, if you have not reviewed the technique before and prepared ahead of time for approach, I would 
not suggest you try it on this patient. I can give you more information if you are interested. 
 
Myself, in my own practice, I would offer this patient a subxiphoid RIMA- (or RGEA) to PDA as a alternative to a DES and lifelong Plavix..... 
 
Mark 
 
Mark Levinson, MD. 
Founder, Editor-in-Chief 
The Heart Surgery Forum® 
Multimedia Cardiothoracic Journal 
URL: http://www.hsforum.com 
URL: http://newoptionsinheartsurgery.com 
Emali: mmlevinson at hsforum.com 
 
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