[HSF] Full metal jacket

[Nasser F. Abou'Seada]

Dear Dave
What was the "Dave Taggard`s
wonderful logic at your local conference last month" ??
NFA
On Dec 10, 2007 5:11 PM, David Harris <drdharris at yahoo.co.uk> wrote:

> Today a cardiologist refers me an 84 yr old for a 3
> vessel CABG. LAD has 90 lesion, and is dominant, wraps
> around the heart. The rest of the vessels are small
> and trash. After I tell him I want to do MIDCAB, he
> then says he will then decide to stent patient, as I
> will not be doing a long lasting operation!!!!
>
> And that was after he listened to Dave Taggard`s
> wonderful logic at our local conference last month!!
>
> Luckily we have another cardiologist that sees the
> logic of MIDCAB`s and hybrid procedures, and feeds us
> single LAD`s
>
> I just bought the 2008 Guiness Book of records for my
> son. The world record for the most accumulated stents
> in 1 patient is 34 (in USA!!!). HA HA HA, they should
> call it the ``debranching coronary procedure``
>
> Dave Harris
>
>
> --- Ben Bidstrup <benjamin.bidstrup at bigpond.com>
> wrote:
>
> > There is an Australian expression but I am not
> > able to put it into this email. It may offend
> > some, but I suspect not a cardiologist!
> >
> > >23 stents !!!
> > >Recommendation is to stent the cardiologists middle
> > cerebral artery
> > >bilaterally .
> > >
> > >Jokes apart the first major series of full metal
> > jackets were after  the
> > >''reconstitution of the LAD'' pölicy by the
> > Maastricht cardioöogy groups so
> > >the Maastricht surgeons would be very knowledgable.
> > Probably if the
> > >myocardium is viable stent endartrectomy and onlay
> > patching with grafting is
> > >the only viable option.
> > >Post oü LMWH , Plavix and aspirin and to maintain a
> > high CO and high
> > >diastolic pressure and IABP if required (Idea is a
> > high coronary flow will
> > >try to decrease one component of Virchow's triad)
> > >Prasanna
> > >
> > >On Dec 9, 2007 4:35 AM, Tohru Asai
> > <toruasai at belle.shiga-med.ac.jp> wrote:
> > >
> > >>  Dear Members
> > >>
> > >>  67yo diabetic Japanese woman with triple vessel
> > disease was recently
> > >>  referred to me. She had DOE and chest discomfort
> > with light exertion. She
> > >>  had multiple stents ( at least 23 stents, mostly
> > cypher!!!) in all three
> > >>  territories. RCA is occluded at ostium, LAD is
> > occluded at the middle and
> > >>  Circumflex has 90% stenosis at the just
> > proximal. In addition, distal
> > >>  targets are quite thin ( distal LAD, PDA...) and
> > 1st and 2nd diagonal have
> > >>  over 95% stenoses, obtuse marginal is obstructed
> > 90% at the beginning. I
> > >>  attached 2 still pictures of coronary angiogram.
> > >>
> > >>  Is this kind of patient more common lately in
> > your practice?
> > >>  What do you do? operate? What procedure?
> > >>  What is your graft chice?
> > >>  endarterecromy considered?
> > >>  What is your strategy of perioperative
> > management of anticoagulation?
> > >>  kill a cardiologist?
> > >>  any comments, please.
> > >>
> > >>  I am moderating a cardiologist-cardiac surgeon
> > session, named "what is an
> > >>  ideal coronary revascularization" next weekend
> > in Kyoto. I am going to
> > >>  present this case.
> > >>
> > >>  BTW my series of diabetic 3VD had over 10 times
> > higher hospital mortality
> > >>  with previous PCI compared to diabetic 3VD
> > without PCI.. My junior staff
> > >>   is
> > >>  writing a paper.
> > >>  --
> > >>  Tohru Asai
> > >>  Shiga, Japan
> > >>
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> > >
> > >
> > >
> > >--
> > >Prasanna Simha M
> > >_______________________________________________
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> >
> >
> > --
> > Ben Bidstrup FRACS FRCSEd FEBCTS
> > Consultant Cardiothoracic Surgeon
> > _______________________________________________
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> >
>
>
> Dr. David G. Harris, FCS, MMED,
> Cardiothoracic Surgeon
> Suite 207
> Kuils River Private Hospital,
> PO Box 1200, Kuils River, 7579, Cape Town, South Africa.
> Tel +27-21-9006411
> Fax +27-21-9006412      Mobile +27-83-3309587
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