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

[Prasanna Simha M]

I do not think that off-pump is "physiological" but the heart lung machine
is definitely not. We want to progress to lesser and lesser invasion in the
hope that we may achieve better results. That is a goal. We have to see if
it can be reached. Telling the patient that it is definitely better is
premature and has got more of marketing than science. I would agree to that
but working towards a non CCPB system is not a deniable goal.
Prasanna

On Dec 22, 2007 8:30 PM, Ani Anyanwu <anianyanwu at hotmail.com> wrote:

> And having your heart lifted out of the chest beating upside down is
> physiological? The sometimes promoted notion that off-pump surgery is
> physiological is part of the great con - I would like to know one thing
> about general anesthesia, or being operated upon that is physiological. Let
> us not pretend there is anything normal about having one's heart operated
> upon - which ever way you dress it heart surgery is a big insult to the
> body.
>
> Again I say there may be benefits to avoiding CPB but let us not pretend
> the patient's desire is what is driving this.
>
> In response to comments on Dr Sergeant's excellent results - I put it to
> you that if he were to adopt his entire system and change only one thing -
> start using CPB - his results would be exactly the same. His results are a
> marker of good surgery, sub-specialization (my understanding is that his
> practice is almost entirely CABG), and good systems management and not
> off-pump surgery.
>
> Ani
>
>
>
> > Date: Sat, 22 Dec 2007 15:54:30 +0530> From: prasannasimha at gmail.com>
> To: OpenHeart-L at lists.hsforum.com> Subject: Re: [HSF] "Patients don't want
> cardiopulmonary bypass" - the great con> CC: > > I would like to know one
> thing that is physiological wrt to cardiopulmonay> bypass ?> Prasanna> > On
> Dec 22, 2007 3:14 PM, <NielsB at aol.com> wrote:> > >> > 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> >> >>
> > **************************************> > See AOL's top rated> > recipes (
> http://food.aol.com/top-rated-recipes?NCID=aoltop00030000000004)<http://food.aol.com/top-rated-recipes?NCID=aoltop00030000000004%29>>
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> -----------------------------------------> >> > > > -- > Prasanna Simha M>
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-- 
Prasanna Simha M