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#1 De:  Alberto Canestri < acanestri@agora.com.ar >
Enviado: Martes, 12 de Octubre de 1999 05:02
Asunto:  Cirugia Cardiovascular/Cardiovascular Surgery 
Respuesta a:
Aneurisma coronario: Tratamiento medico versus quirurgico cuando y como se emplea tratamiento quirurgico?
Responder en castellano. Gracias.
Responde Dr.M.A.Chiappe:
el diagnóstico de aneurisma coronario se hace frecuentemente cuando se asocia a una patología obstructiva del árbol coronario, y suelen
verse en el mismo o diferente territorio de la coronaria obstruída. Nuestra conducta es tratar la obstrucción y no tocar el aneurisma
salvo que su tamaño sea considerable (> 1 cm); en este caso corresponde la ligadura con exclusión del mismo y el consiguiente bypass al territorio coronario distal.

Reply to:
Coronary Aneurym:
Medical us surgical treatment when and how do you employ. Surgical treatment?
Reply in Spanish. Thanks.
Dr. M. A. Chiappe replies:
The diagnosis of coronary aneurysm is frequently made when it is associated to an obstructive pathology of the coronary tree, and it is usually seen in the same or different territory of the obstructed coronary artery. Our management is to treat the obstruction and not to touch the
aneurysm, unless its size is important (> 1cm); in this case it is proper to make a ligature with exclusion of it, and the following bypass to the distal coronary territory.
Alberto Canestri, M.D.

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#2 De:  Rui Manuel de Sousa Sequeira Antunes de Almeida <almeidar@certto.com.br>
Enviado: Jueves, 14 de Octubre de 1999 11:55
Asunto: Valvulas Mecanicas/Mechanical valves
Gostaria de saber, dos participantes do Forum, quais as proteses mecanicas mais usadas (porcentagem) e posiþÒo, bem como, o regime de
anticoagulaçao que preferem. Na escolha da protese gostaria que citassem se o uso da mesma deve-se a no haver outra disponivel ou a
da escolha do cirurgiao e qual seria a protese ideal. Agradezco anticipadamente.

I would like to know, from the participants of the Forum, which are the most used mechanical prosthesis (the percentage) and if possible, also the anticoagulation regimen that you prefer. When choosing the prosthesis, I would like you to tell me, if you use it because there is no
other available, or because the surgeon chooses it, and what  would be an ideal prosthesis. I thank you in advance,
RUI SEQUEIRA DE ALMEIDA, M.Sc., MT-SBCC-V
Cirurgiao Responsavel
Instituto de Molestias Cardiovasculares de Cascavel- Brasil
Professor Assistente de Medicina
UNIOESTE - Universidade Estadual do Oeste do Parana

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#3 De: Alberto Canestri < acanestri@agora.com.ar >
Enviado: Martes, 19 de Octubre de 1999 04:41
Asunto: Cirugia Cardiovascular/Cardiovascular Surgery
Estimados Colegas miembros de la Lista de Cirugia: en mi caracter de Moderador y Coordinador de la misma, quiero informarles que con motivo de un evento cientifico a desarrollarse en la ciudad de Cordoba, estaran en esta Los Dres.Calafiore y A.Juffe Stein entre el 20 y 23 del cte. Dado que ambos son dos de los principales expositores de este Congreso Virtual, seria interesante a aprovecharlos para alguna consulta acerca de sus interesantes exposiciones.

Dear colleagues members of the surgery list: As a moderator and coordinator of this, I would like to inform that as regards the scientific event to be held in Córdoba Drs. Calafiore and A. Juffe Stein  are going to be there between 20th and  23th. AS they both  are two of the most important lecturers of this Virtual Congress, it would be interestig taking advntage on them about any question on their interesting lectures.
Alberto Canestri

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#4 De:  Miguel A. Chiappe < mchiappe@agora.com.ar >
Enviado: Martes, 19 de Octubre de 1999 04:43
Asunto: Cirugia Cardiovascular/Cardiovascular Surgery
Respuesta a la pregunta del Dr. Rui S. de Almeida
Contesta Dr. Miguel A. Chiappe:
Las protesis mecanica mas utilizada por nosotros, son las de doble disco oscilante, casi en un 100% de los casos. Si bien cada uno de
los cirujanos tiene su preferencia por alguna marca en particular, en nuestro medio, muchas veces son las obras sociales quienes adjudican
un determinado modelo en base a su precio de costo. Respecto a la protesis ideal, es por todos conocido que aun se esta buscando.
Respecto al régimen de anticoagulacion, usamos el Coumadin (warfarina) o el Sintrom (acenocumarol) hasta alcanzar un Rin entre 2.5 y 3.5

Replying Dr Rui S. De Almeida questions
Answers Dr. Miguel A. Chaippe:
The mechanical prosthesis that we more frequently use are the ones of double oscillating disc, in almost  100% of the cases. Although each surgeon has his preference   for a particular trade mark, in our context, the health care services are many times the ones which indicate a
determined model according to the price. As regards the ideal prosthesis it is known that   it is still being looked for.
As regards the anticoagulation procedures, we use Coumadin (warfarine) or Sintrom (acenocumarol) till  a Rin between 2,5 and 3,5 is reached.

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#5 De: Rui Manuel de Sousa Sequeira Antunes de Almeida <almeidar@certto.com.br
Enviado: Miercoles, 20 de Octubre de 1999 08:09
Asunto: Cirurgia de Batista/Batista surgery
Gostaria de saber qual a experiencia que cada participante tem com a Cirurgia de Batista (Ventriculectomia Parcial), em casos de Miocardiopatias dilatadas e Isquemicas e quais seus resultados.

I would like to know about each participant's experience with the Batista Surgery (partial ventriculotomy) in cases of dilated and ischemic cardiomyopathies, and which are its results.
RUI SEQUEIRA DE ALMEIDA, M.D., M.Sc.

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#6 De:  Joao Carlos Ferreira Leal <joaocarlos@bio.braile.com.br>
Enviado:  Martes, 09 de Noviembre de 1999 06:13
Asunto: sobre tema livre = radial em pacientes submetidos/About the Brief Communication: Radial artery in patients that underwent...
Caro Hector,
Seu trabalho sobre espasmo em arteria radial na revascularizao do miocardio esta muito bom, entretanto, gostaria de saber se as anastomoses proximais ( arteria radial ) foram na aorta ou em "Y"com a arteria toracica interna esquerda, quando resvascularizou a diagonail, diagonalis ou marginal.....? mais uma vez quero parabenizarlo por este tema livre muito impotante para nos cirurgioes.
Um forte abrazo.

Dear Hector:
Your work on spasm in radial artery in revascularization of myocardium is very good; meanwhile, I would like to know if proxymal anastomosis (radial artery) were in the aorta or in "Y" with a left internal mammary artery, when you revascularized diagonal artery, diagonal or marginal arteries...? Once more I wanted to congratulate you for this Brief Communication, very important for us, surgeons.
Hugs, Joao Carlos Leal.

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#7 De: Armando Pacher <apacher@satlink.com>
Enviado: Miercoles, 10 de Noviembre de 1999  05:51
Asunto:  mortalidad/mortality
El Dr. Luis Aramayo ( laramayo@intramed.net.ar )envia la siguiente pregunta:
Agradeceria alguna referencia para encontrar datos acerca de mortalidad en los distintos centros de cirugia cardiovascular en la Argentina, mas especificamente en lo relacionado con cirugia coronaria.- Desde ya, Gracias.-

Dr. Luis Aramayo ( laramayo@intramed.net.ar ) sends the following question
I would be grateful if you could provide me with some reference to find data about mortality in different cardiovascular surgery centers in Argentina, more specifically, regarding coronary
surgery. Thanks, Dr. Luis Angel Aramayo

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#8 De: Hector Bonaccorsi <hectorb@arnet.com.ar>
Enviado: Jueves 11de Noviembre de 1999 05:53
Asunto:  Sobre tema livre = radial em pacientes submetidos/About the Brief Communication: Radial artery in patients that underwent...
Caro Joao Carlos:
Como bien te imaginas en la mayoria de los pacientes a los cuales se les realizo revascularizacion con Arteria Radial, la anastomosis proximal del bypass fue realizada en la Arteria Mamaria Interna y las anastomosis distales en "Y" a las arterias receptoras del mismo cuando estas eran mas de una. En los primeros tiempos(hace aproximadamente 4 anios) cuando comenzamos a utilizar la Art. Radial se hacia la anastomosis proximal directamente en la Aorta pero poco despues en base a nuestra experiencia y la de los demas grupos esto se cambio por la modalidad que acabo de describirte y que seguramente tu conoces bien. Un gran abrazo latinoamericano.

Dear Joao Carlos:
As you can well imagine, in most patients on whom I perform revascularization with radial artery, proxymal anastomosis of bypass was carried out in the internal mammary artery, and distal anastomosis in "Y" to the receptor arteries of it when these were more than one. In those first times (approximately 4 years ago) when we began to use the radial artery, proxymal anastomosis was performed directly in the aorta, but shortly afterwards, based in our experience, and that of the rest of the groups, this was changed to the modality I have just described to you, and that surely you know well. Latin-American hugs, Dr. Hector Bonaccorsi

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#9 De:  Alberto Canestri < acanestri@agora.com.ar >
Enviado: Jueves, 11 de Noviembre de 1999 05:50
Asunto: Cirugia Cardiovascular/Cardiovascular Surgery
Quisiera poner a la consideracion de  la lista y felicitar al Dr.Antunes de Coimbra, Portugal por su trabajo sobre comisurotomia
mitral. Por sus excelentes resultados inmediatos y su completo follow up, me parece un trabajo muy importante para elaborar comparacione
con la valvuloplastia con balon. Quisiera pedirle al Dr. Jorge Tomassi su opinion sobre este trabajo y formularle una pregunta al Dr.Antunes:
es mi opinion que la valvuloplastia con balon no solamente no resuelve el compromiso del aparato subvalvular, si no que puede a traves de una
sobredistension del anillo, predisponer  a una insuficiencia mitral. ¿cual es su opinion al respecto?

I would like to present to the list and congratulate Dr. Antunes from Coimbra, Portugal for his job on mitral commissurotomy. Due to its excellent immediate results and its complete follow up, it seems to me a very important work to make comparisons with valvoplasty with balloon. I would like to ask Dr. Jorge Tomassi his opinion on this work, and ask a question to Dr. Antunes: it is my opinion that valvoplasty with balloon not only does not solve the involvement of the subvalvular apparatus, but also can predispose to a mitral insufficiency through an
overdistention of the ring. What is your opinion about it?
Alberto Canestri

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#10 De:  Juan Jorge Tommasi <jtommasi@way.com.ar>
Enviado: Jueves, 11 de Noviembre de 1999 08:18
Asunto: vasoplegia. mixomas/Vasomotor paralysis. Myxoma
Desearia consultar, si existe experiencia en los distintos equipos sobre casos operados de mixoma y vasoplegia postoperatoria, en
relacion con alguna secrecion humoral por parte del tumor que pueda llegar a provocarla, una vez descartadas otras causas mas comunes de
la misma. Tenemos un caso de auricula izquierda de mas de 7 cm de diametro mayor , extraido con treinta minutos de CEC, y vasoplegia
inmediata a la salida de bomba. Tambien desearia sugerencias acerca del tratamiento mas efectivo, en lineas generales.

I would like to consult, if there is experience in the different teams, about cases of operated myxoma, and postoperative vasomotor
paralysis, regarding some humoral secretion by the tumor that may cause it, once other causes for it, more ordinary, have been
dismissed. We have a case of left auricle of more than 7cm in its greatest diameter, extracted with thirty minutes of ECC, and
immediate vasomotor paralysis to the pump outflow. I would also accept suggestions about the most effective treatment, just broadly.
Dr. juan J.Tommasi

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#11 De:  Hector Bonaccorsi <hectorb@arnet.com.ar>
Enviado: Jueves, 11 de Noviembre de 1999 05:53
Asunto: Sobre tema livre = radial em pacientes submetidos/About the Brief Communication: Radial artery in patients that underwent...
Caro Joao Carlos:
Como bien te imaginas en la mayoria de los pacientes a los cuales se les realizo revascularizacion con Arteria Radial, la anastomosis
proximal del bypass fue realizada en la Arteria Mamaria Interna y las anastomosis distales en "Y" a las arterias receptoras del mismo cuando
estas eran mas de una. En los primeros tiempos(hace aproximadamente 4 anios) cuando comenzamos a utilizar la Art. Radial se hacia la
anastomosis proximal directamente en la Aorta pero poco despues en base a nuestra experiencia y la de los demas grupos esto se cambio por la modalidad que acabo de describirte y que seguramente tu conoces bien. Un gran abrazo latinoamericano.

Dear Joao Carlos:
As you can well imagine, in most patients on whom I perform revascularization with radial artery, proxymal anastomosis of bypass was carried out in the internal mammary artery, and distal anastomosis in "Y" to the receptor arteries of it when these were more than one. In those first times (approximately 4 years ago) when we began to use the radial artery, proxymal anastomosis was performed directly in the aorta, but shortly afterwards, based in our experience, and that of the rest of the groups, this was changed to the modality I have just described to you, and that surely you know well. Latin-American hugs,
Dr. Hector Bonaccorsi

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