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

Sat Dec 22 10:53:26 EST 2007

Ani,

See the recent paper in the December Annals: " Neurocognitive Outcomes 3
Years After Coronary Artery Bypass Graft Surgery: A Controlled Study".

I think your excellent comments on the scientific merits of cardiac surgery
fall on deaf ears (I hope the deafness is reversible). I have been following
the HSF forum since its inception. It is my experience that this is a great
forum for practical advice and sharing surgical techniques. Strangely
though, our minds are impervious to scientific thoughts, particularly when
they involve statistics. 

Still, I do hope you continue your intelligent and balanced commentaries on
this forum. I am glad to see that you will be teaching at the post-graduate
forum at AATS. 

Ajit Damle

-----Original Message-----
From: openheart-l-bounces at lists.hsforum.com
[mailto:openheart-l-bounces at lists.hsforum.com] On Behalf Of Ani Anyanwu
Sent: Saturday, December 22, 2007 9:00 AM
To: openheart-l at lists.hsforum.com
Subject: RE: [HSF] "Patients don't want cardiopulmonary bypass" - the great
con

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)> >
_______________________________________________> > OpenHeart-L mailing list>
>> > Send postings to:> > OpenHeart-L at lists.hsforum.com> >> > To
UNSUBSCRIBE, to CHANGE email address, or to view archives:> >
http://mmp.cjp.com/mailman/listinfo/openheart-l> >> > All messages
transmitted by the OpenHeart-L are subject to the policies> > and> >
disclaimers posted at:> > http://www.hsforum.com/listdisclaim> >
-----------------------------------------> >> > > > -- > Prasanna Simha M>
_______________________________________________> OpenHeart-L mailing list> >
Send postings to:> OpenHeart-L at lists.hsforum.com> > To UNSUBSCRIBE, to
CHANGE email address, or to view archives:>
http://mmp.cjp.com/mailman/listinfo/openheart-l> > All messages transmitted
by the OpenHeart-L are subject to the policies and > disclaimers posted at:>
http://www.hsforum.com/listdisclaim>
-----------------------------------------

_________________________________________________________________

Get Hotmail on your mobile, text MSN to 63463!

http://mobile.uk.msn.com/pc/mail.aspx_______________________________________
________

OpenHeart-L mailing list

Send postings to:

 OpenHeart-L at lists.hsforum.com

To UNSUBSCRIBE, to CHANGE email address, or to view archives:

http://mmp.cjp.com/mailman/listinfo/openheart-l

All messages transmitted by the OpenHeart-L are subject to the policies and 

disclaimers posted at:

http://www.hsforum.com/listdisclaim

-----------------------------------------