[HSF] Non inferiority of Percut Trache

[Nasser F. Abou'Seada]

Mike .... I echo your opinion 

NFA

> -----Original Message-----
> From: openheart-l-bounces at lists.hsforum.com [mailto:openheart-l-
> bounces at lists.hsforum.com] On Behalf Of Michael Sekela
> Sent: Sunday, November 12, 2006 11:06 PM
> To: OpenHeart-L at lists.hsforum.com
> Subject: RE: [HSF] Non inferiority of Percut Trache
> 
> In 20 years of practice I've never had a problem with open trach. For the
last 15
> years I've done them in the icu under local without anesthesia present
using a
> headlight. Moving  these patients to the or is the biggest hassle of the
procedure.
>      Perc trach seems OK, but open is very simple and safe.
>               Mike
> 
> -----Original Message-----
> From: Hgrmd at aol.com
> To: OpenHeart-L at lists.hsforum.com
> Sent: 11/12/06 11:40 AM
> Subject: Re: [HSF] Non inferiority of Percut Trache
> 
> John,
>   Maybe I'll have to revisit the question.  However, other than  the
bother
> of going to the OR, complications from open trachs in my practice is
> essentially nonexistent.  Clinically important infection?  Haven't  seen
it  Bleeding
> requiring further intervention?  Very rarely.   Even then, it's oozing
that
> can be easily controlled by a pursestring of 2-0  Nylon around the stoma,
which
> can then be removed a couple of days later. I wish  I knew the true
incidence
> of laceration of the membranous trachea with the  percutaneous approach.
If
> it's truly only a couple of cases, then that's  not so bad.  However, I
can
> almost guarantee you that the risk of  litigation with such a complication
would
> have to be quite high.  One  question, John, how soon would you be willing
to
> do a percutaneous trach after a  sternotomy?  With the open trach, we
> generally wait a minimum of 10  days.
> Hal
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