[HSF] Aortic Dissection early after AVR with CABG

[Yong-In Kim]

Congratulations for your successful re-sternotomy repair of Ao dissection.
You did great job.
Thanks for the nice pictures!
 
Yong-In L Kim, MD, PhD
Inje Univ.Seoul Paik Hospital
Seoul, Korea
yonginkim



> From: toruasai at belle.shiga-med.ac.jp> To: OpenHeart-L at lists.hsforum.com> Subject: Re: [HSF] Aortic Dissection early after AVR with CABG> Date: Sun, 18 May 2008 02:39:23 +0900> CC: > > The operation literally took 5 hours. The right femoral a and v are ready > prior to sternal reentry. The most nasty adhesion was between left lung and > left hemisternum. Care was taken to dissect adhesion step by step. After a > part of right atrium exposed, I went on CPB with femoral arterial cannula > and femoral v and SVC via right appendage. Performed rest of dissection > around the ascending aorta on pump. Cooled down to 20C followed by circ > arrest. To open aorta, I found transverse intemal tear posteriorly > initiating from heel bite of PDA saphenous vein graft. Aortotomy closure > line, which I always do very low, appeared intact.> > As usual, open distal anastomosis with felt reinforced distal aortic stamp > and Gelweave graft was performed at the level just below the innominate > take-off. GRF was used to obliterate remained distal pseudolumen. The > proximal aorta was anastomosed in the same manner, but without touching > previous aortotomy closure line. Lastly saphenous vein was anastomosed to > the graft.> > I am cautiously optimistic that he will do well.> (BTW Michael, those CT pictures were obtained by 16 slice (not 64). It is > still good with nice preparation! Great to see you in NY.)> ciao> ----> Tohru Asai> PS. I upload serial pictures.> op1: at the first operation before AVR with CABG> op2: at the first operation after AVR with CABG> op3: at the second operation before circ arrest> op4: at the second operation inside the aorta> op5: at the second operation after completing procedure 
_________________________________________________________________
Explore the seven wonders of the world
http://search.msn.com/results.aspx?q=7+wonders+world&mkt=en-US&form=QBRE