[HSF] New case- CAD + Leriche

Fri May 16 10:59:44 EDT 2008

I agree. Tell your chief his efforts were appreciated. It was a pleasure to listen to someone else say MR and CHF are not about the EF but the volumes. stupid!
tea

----- Original Message ----
From: "Laudito, Antonio" <laudito at musc.edu>
To: "OpenHeart-L at lists.hsforum.com" <OpenHeart-L at lists.hsforum.com>
Sent: Friday, May 16, 2008 10:43:25 AM
Subject: RE: [HSF] New case- CAD + Leriche

Any,

I appreciated your talk very much. In my humble opinion, the mitral session in the post graduate course was simply superb.

Thank you for opening the eyes of the cardiothoracic surgical community on the  literature.

Antonio
Antonio Laudito, MD
Cell: +393334403881
>From USA: 011393334403881
Email: laudito at musc.edu
________________________________________
From: openheart-l-bounces at lists.hsforum.com [openheart-l-bounces at lists.hsforum.com] On Behalf Of Ani Anyanwu [anianyanwu at hotmail.com]
Sent: Friday, May 16, 2008 10:31 AM
To: openheart-l at lists.hsforum.com
Subject: RE: [HSF] New case- CAD + Leriche

Zhandong

We use the levitronix device (marketed in USA as Thoratec Centrimag) but the last such case I used the tandem heart which has the advantage of potential for percutaneous removal.

Was nice to meet you too at AATS - not everybody liked my talk though as you can imagine...

Ani

> To: OpenHeart-L at lists.hsforum.com> Subject: Re: [HSF] New case- CAD + Leriche> From: zzhoumd at pol.net> Date: Fri, 16 May 2008 13:15:56 +0000> CC: > > > Ani,> > Which system are you using now for such short term support?> > BTW, it was great pleasure to hear you talk and meet you in person.> > Zhandong Zhou> > Sent via BlackBerry by AT&T> > -----Original Message-----> From: Ani Anyanwu <anianyanwu at hotmail.com>> > Date: Fri, 16 May 2008 12:53:23 > To:<openheart-l at lists.hsforum.com>> Subject: RE: [HSF] New case- CAD + Leriche> > > > I worry about not having a good and safe way to use a IABP and the possibility of severe lower extem ischemia if we have any problem with low output. > > > Tom> > > Dr Martin> > In such a case we would go straight to temporary mechanical support (LVAD) and not mess around with IABP if we have low-output. > > Few reasons for this rationale: 1) In reality IABP is probably of limited effectiveness in increasing cardiac output
 except if cause is myocardial ischemia 2) Avoids risk of vascular complications 3) The alternative - IABP with high dose catecholamines causes selective vasoconstriction in some vascular beds and may predispose to renal, hepatic, gastrointestinal and limb complications. We feel that having a patient with a good cardiac output from the onset, without need for vasoconstrictors may be preferable for organ perfusion and may prevent decline into multi-organ failure. > > In this setting we leave the VAD in for 3 to 4 days then explant - at this time myocardial stunning should subside, as should bleeding and need for transfusions, the patient can be diuresed to a nice low CVP and such a short period will hopefully avoid VAD related complications.> > Ani> > > > > To: OpenHeart-L at lists.hsforum.com> Subject: Re: [HSF] New case- CAD + Leriche> Date: Fri, 16 May 2008 07:51:32 -0400> From: tdmartin2000 at aol.com> CC: > > Gentlemen> Thanks for the input so soon. To
 answer some of the questions posed so far- he does pass the eyeball test and in fact works at the info desk at our hospital, he does smoke but "down to 5 a day", his mitral and aortic valves are OK and I think the low if may be secondary to his MI, his legs are fairly ischemic and currently I do not know the status of his vessels below the inguinal lig. I have thought about all of these approaches and am considering either ax-fem (which I am not?a real fan of) or combined ABF/CAB which I have done on several occasions.> I worry about not having a good and safe way to use a IABP and the possibility of severe lower extem ischemia if we have any problem with low output. > No one has addressed the issue of timing yet in the face of a nonQ infarct?> > Tom> > > -----Original Message-----> From: Hgrmd at aol.com> To: OpenHeart-L at lists.hsforum.com> Sent: Fri, 16 May 2008 7:05 am> Subject: Re: [HSF] New case- CAD + Leriche> > > > John,> Agree with your comments
 except for the ascending aortic graft to the > iliac. Guaranteed much simpler is a conventional axillary (either right or > left) > bifemoral bypass. Ax-fems have been used for years with good results. For > the first 8 years of my practice, at least half of my time was spent doing > peripheral vascular surgery (I still do a few carotids). I don't currently > read much about vascular surgery, but I know that this is a simple, relatively > atraumatic procedure. BTW, do you know of any studies comparing the 2 > techniques?> > Hal> > > > **************Wondering what's for Dinner Tonight? Get new twists on family > favorites at AOL Food. > (http://food.aol.com/dinner-tonight?NCID=aolfod00030000000001)>_______________________________________________> 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> -----------------------------------------> >_______________________________________________> 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> -----------------------------------------> _________________________________________________________________> > http://clk.atdmt.com/UKM/go/msnnkmgl0010000007ukm/direct/01/_______________________________________________> 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> -----------------------------------------
_________________________________________________________________

All new Live Search at Live.com

http://clk.atdmt.com/UKM/go/msnnkmgl0010000006ukm/direct/01/_______________________________________________
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
-----------------------------------------
_______________________________________________
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
-----------------------------------------