[HSF] Graft Flow Measurement

[Salerno, Tomas]

Medstim

TS

-----Original Message-----
From: openheart-l-bounces at lists.hsforum.com [mailto:openheart-l-bounces at lists.hsforum.com] On Behalf Of DukeB60 at aol.com
Sent: Wednesday, November 12, 2008 9:19 AM
To: OpenHeart-L at lists.hsforum.com
Subject: Re: [HSF] Graft Flow Measurement

Tomas,
    Which system of flow measurement do you  currently use?
 
 

 
In a message dated 11/12/2008 8:17:16 A.M. Central Standard Time,  
TSalerno at med.miami.edu writes:

Infusing  cardioplegia into a graft does not mean that the graft is patent, 
as blood may  be forced into an area of critical stenosis. Unfortunately, with 
the current  state of technology, basically we have to rely on either flow 
measurements,  which is which I use, or SPY, which is also an alterntive. 
Regardless, any  study that describes graft patency ought to, at least, document that 
the  grafts are patent at time of chest closure 

Tomas

-----Original  Message-----
From: openheart-l-bounces at lists.hsforum.com  
[mailto:openheart-l-bounces at lists.hsforum.com] On Behalf Of Michael  Firstenberg
Sent: Wednesday, November 12, 2008 9:12 AM
To:  OpenHeart-L at lists.hsforum.com
Subject: Re: [HSF] Graft Flow  Measurement

Interestingly I had a patient ask me this very question a  couple of days
ago.

I have been using Spy more and more - but like  every other technology there
are a variety of limitations.  since this  question appears to come up here
every couple of months, it does raise the  question what and how do we use
the data?  I give cardioplegia down  every graft and record the flow rates
and also document my thoughts on the  quality of the graft - this has come in
handy when patients come back and a  graft is down.  It then makes sense
(sometimes).  But, there are  some many variables to graft patency that is
leaving the OR with  documentation of some blood flow going down a  graft
enough?

-michael




On Wed, Nov 12, 2008 at  8:57 AM, Salerno, Tomas 
<TSalerno at med.miami.edu>wrote:

>  Normal EKG and hemodynamics can be normal in the presence of occluded  new
> grafts during coronary surgery. Humbling experience for surgeons  who 
routine
> perform quality control of anastomoses. Only one way to  know if grafts are
> patent ie, we must measure flows or use other  technology such as spy.
> Angiography intraoperatively is not  feasible.
>
> Tomas
>
> -----Original  Message-----
> From: openheart-l-bounces at lists.hsforum.com  [mailto:
> openheart-l-bounces at lists.hsforum.com] On Behalf Of Donald  Ross
> Sent: Wednesday, November 12, 2008 4:36 AM
> To:  OpenHeart-L at lists.hsforum.com
> Subject: Re: [HSF] Graft Flow  Measurement
>
> This opcaber only measures flow occasionally, for  either a graft which
> looks odd or EKG or TEE suspicion of a  problem.
> Don
> On 12/11/2008, at 8:51 AM, Ajit Damle  wrote:
>
> >
> >
> > Question fro  OPCABers:
> >
> >
> >
> > Is graft flow  measurement the standard of care in off-pump cases?
> > Which
>  > method? What parameters?
> >
> > (For me, I measure  flows on my on pump CABGs).
> >
> >
> >
>  > Ajit Damle
>  >
> >
> >
> >  _______________________________________________
> > 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
>  -----------------------------------------
>  _______________________________________________
> 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
-----------------------------------------
_______________________________________________
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
-----------------------------------------


**************AOL Search: Your one stop for directions, recipes and all other 
Holiday needs. Search Now. 
(http://pr.atwola.com/promoclk/100000075x1212792382x1200798498/aol?redir=http://searchblog.aol.com/2008/11/04/happy-holidays-from
-aol-search/?ncid=emlcntussear00000001)
_______________________________________________
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
-----------------------------------------