[HSF] "Patients don't want cardiopulmonary bypass" - the great con

[NielsB at aol.com]

This discussion is always interesting. I must again   one of the many 
excellent quotes of my   great friend and previous partner in Buffalo:

"Why do people feel so safe when they enter an airplane? Because the pilot 
goes with you, and he would probably not go if the plane was unsafe.
But when the cardiac surgeons say: we are going on pump it is not exactly 
true, because the surgeons does not go on pump himself, only the patient"

Of course it does not mean that the pump is   a priori bad, sometimes we need 
it sometimes not, it is a tool and an important one some times.

We should not be so fixed on this issue any more, but also not ignore the 
issues. As the previous writer said, maybe a couple of hours on the pump will 
rejuvinate the brain. Of course that is   a joke as far as we know, because I 
really dont find much evidence that the brain is better with than without pump. 
Most sudies show that   cognitive functions etc are worse or equal with pump 
not better.

So maybe   most patients do not understand all this things, but as surgeons 
maybe it   is our responsibility to use the tool when it is indicated and 
necessary, and in my opinion in CABG it is not usually required.

Jacob Bergsland


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