[HSF] Type I Dissection

[Tea Acuff]

If we can take a step back from the details and specifics of this case, I would like to share a few reflections:
 
1)The cases we talk about are amazing. I realize there is some bias towards success, but the type of therapies on which we embark and the patients that we dive into stagger me. I have pursued some of what seem to me daunting projects, but the cases that others including Ed present make words like coward flash before my eyes as I think about my feelings of what I would like to do when faced with these patients.
2)  Accepting the above, if we could tell before hand with a high degree of certainty for even a few percent, the nature and prognosis of what we rush to rescue, we would save ourselves, our patients, our families, and all of those around without a voice huge savings of assets, energy, and capital. High risk, to some extent, means inappropiate match of patient to technique.
3) If we, on the other hand, could successfully apply our skills on a large minority of the portion of patients that we (or those that would send them) consider inoperable, we would be as heroic as we are now for other thoroughly explored and now established indications.
 
This is exactly why I would like to get the message for the use of better imaging and diagnostic tools to the surgical community specifically and cardiac medicine in general. Just as we need to explore new techniques and post operative care, we need to explore the indications and selections for our patients. If we let cardiologists or others perform that task primarily, we will fail ourselves and our patients more than necessary.
 
tea