[HSF] AATS

[Donald Ross]

I agree, Hal.
Ani has shown himself to be influenced by preconceived ideas like the  
rest of us.
Just because he has seen an odd SVG acutely  occluded the cause must  
be  traumatic harvest. Ani, welcome to anecdote land!
SVGs start to fall off the perch at ten years so why is a good eight  
year patency so special?
I can't understand why anyone would want to use them for a  
significant stenosis anyway, but that is just my unsubstantiated view.
So, if you need a CABG Ani, Martin Misfeld can now fix you up with an  
anaortic arterial opcab.
Don

On 18/05/2008, at 8:24 AM, Hgrmd at aol.com wrote:

> Ani,
>   For such an analytical fellow, I'm surprised at the conclusions   
> you've
> drawn about endoscopically harvested veins.  As far as I know,   
> there's never
> been a head to head study comparing open versus closed harvesting   
> of the veins
> in regards to patency.  I have the clinical experience of  having  
> done CABG's
> for at least 10 to 12 years of open veins and around 6-8  years of  
> endoveins.
> I certainly haven't perceived a difference in  patency.  In other  
> words, I
> can't tell that a lot more cases are coming to  cath with closed  
> grafts as
> compared to open harvested veins.  Indeed, there  may be a  
> difference, but it has
> been imperceptible to us.
>   Our P.A.'s are extremely skilled at rapidly delivering an  
> endoscopic  vein
> through a 2 cm stab wound (usually no incision in groin at all)  
> that rarely
> has avulsed branches requiring repair with 7-0.  Quite frankly, I  
> can't  tell
> the difference in appearance between open and closed harvested  
> veins.   Your
> point about dilating with blood and papaverine is well taken.   
> That  preparation
> may be less stressful to the vein's endothelium.  However, in  the  
> end, no
> matter how you prep them, the veins die no matter what you do to   
> them.  That's
> why it is imperative that we spend more time harvesting  arterial  
> conduits and
> not letting concerns about time supervene.
>
> Hal
>
>
>
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