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Oct 1, 2008 3:00 PM
by: Ahmad Rajaii-Kh...
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Myocardial Perfusion in Beating Heart Surgery
Posted:
Aug 3, 2004 2:17 PM
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[nobr]"Simultanous Antegrade/Retrograde Normothermic Blood Perfusion of the Heart in Valvular and Other Complex Surgery (Beating Heart Valvular Surgery): A New Concept in Myocardial Protection" by Tomas Salerno of Miami, Florida, provides a new method of protecting the heart during beating heart procedures.
Read his proposed technique at: http://www.ctsnet.org/doc/9020
Editor Gianni Angelini has also added a thoughtful commentary: http://www.ctsnet.org/doc/9427
What are your thoughts? Record them here.
Tom Ferguson [/nobr]
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9/23/08
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Re: Myocardial Perfusion in Beating Heart Surgery
Posted:
Oct 1, 2008 3:00 PM
in response to: Thomas Ferguson
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Dear colleages:
The term beating heart surgery which have been used in the OPCAB litrature as a synonym to opcab has aquired the values attached to opcab. These values include avoiding CPB and simplicity. In the case of valve surgery on the other hand coronary perfusion adds to the complexity of the operation and therefor its routine use is not justified. I have actually used this concept since 1987. In cetain selected rare situations ,during AVR , X clamping + coronary perfusion and during MVR in patients with very low LVEF ,no clampimg + beating and even fibrilating is quite comforting. Especially when a complex repair is anticipated in such a patient.Obviosly deairing needs special attention and if fibrilation is used the rewarming should be timed properly to avoid waisting time.
It is important to note that the physiology of coronary perfusion is very interesting and any student of cardiology and cardiac surgery should be familair with the valuble work of Dr. Salerno. But in practical cardiac surgery The value of cardioplegea should not be undermined.
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