AW: [HSF] a carotid and coronary case

[Tea Acuff]

The STS probably has real numbers but they would be unofficial anyway. I bet 1/2 to 2/3 of CV surgeons in the US do vascular , thoracic and cardiac as only a few surgeons are in large enough institutions to do only cardiac or especially only thoracic. Some do just 
C and T also. It may be harder for the younger surgeons to get vascular hospital privileges today, however, so this may change over the next decade.
Surgery is team sport despite the ego manics so characteristic of the speciality. Interestingly the ego manics are even more likely to insist on a consistent team. (Any challenges on that sweeping generalization?) Team work saves lives, period. Witness July in training. If not why have heart teams when anyone will do? Surgery is seldom practiced tag team, so it is not done as well.
 

tea


----- Original Message ----
From: Tohru Asai <toruasai at belle.shiga-med.ac.jp>
To: OpenHeart-L at lists.hsforum.com
Sent: Monday, August 6, 2007 8:17:28 PM
Subject: Re: AW: [HSF] a carotid and coronary case


Hal, Roberto
I think the ratio of CEA vs stenting are largely more depending on
availability of competent surgeons rather than procedure related
characteristics or anatomy. Or I should say that presence of competent
surgeons is predicated for the discussion. From this thread, I recognized
you, Roberto, Ed and others as competent surgeons for simultaneous CEA/CABG.
I sincerely admire your touch of art in surgery!

In the era of endovascular explosion, are you rare species among US or
German cardiac surgeons? What percentage of cardiac surgeons do you think
are your species? No matter how loudly you claim that your CEA carries lower
stroke rate, probably those who are not competent most likely end up with
stenting. If Ani's comment is right about two team approach ending up not
better outcome, partially I agree, a single surgical team is supposed to be
best to achieve the outcome. Ideally other cardiac surgeons should send
these patients to a few specialists, but probably they don't do so and  do
cab in their way ( anaortic, OPCAB, ONCAB,,,whatever they prefer rather than
data) with second best carotid procedure, which I am not sure, namely
stenting.


This is just like a futile discussion between multistenting vs CABG for
multivessel coronary disease. Medical doctors tend to do what he/she want to
do and maybe prepare theory after that. But for myself, I love art of
surgery and am eager to learn CEA. I am a son of music teachers.
-- 
Tohru Asai

Reading is like the sex act - done privately, and often in bed.
Daniel J Boorstin

Surgery is also like the sex act - done privately, and in bed (in OR).


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