[HSF] OPCAB

[erdinç naseri]

Dear Dr.Bergsland,
statistically what do you mean by better in copmparing on and off pump 
surgery.Better long term patency, better free of coronary 
reintervention,better cosmetics result,better (lower) mortality and 
morbidity,... and the list goes on .Although all of us have heard enough of 
this disscussion I have to add my point which may be of little 
benefit.Started doing OPCAB in 1999 and about 1500 cases up to now .I wonder 
who can claim that an anastomosis on proximal OM 2-3 which is 1 mm and 
calcific and may need endarterectomy can be made more precisely on a beating 
rather than still
heart.conclusion:OPcab is a very important tool in armamenterium of every  
cardiac surgeon and can be applied to most but not all CAD patients.As 
experience increases the percentage will increase butsince  this is a 
trilogue among the heart ,anesthesia team and surgical team it can not be 
100%.
Erdinc

>From: NielsB at aol.com
>Reply-To: OpenHeart-L at lists.hsforum.com
>To: OpenHeart-L at lists.hsforum.com
>Subject: Re: [HSF] OPCAB
>Date: Tue, 13 Mar 2007 03:39:56 EDT
>
>To the previous statements on OPCAB I want to add a favorite one from Tom,
>from OPCABs early days in Buffalo: This is regarding the amount of ONCAB
>surgery:   Not everyone should be a pilot on the F-16.
>
>Well the point is that most of the cardiac surgeons could be OPCAB surgeons
>if they wanted to, look at all the papers in the literature on teaching 
>OPCAB.
>And look at the fact that the Japanese doing 60% OPCAB and 60% all 
>arterial.
>Could it have some connection with the fact that the Japanese are making 
>Toyota
>as well and not Chevy.
>
>Sorry to say it is too bad that we as cardiac surgeons dont have a better
>product to compete with the   stents that are really not that great but 
>still
>controlling the market.
>
>Endoscopic LIMA-LAD, multiple arterial grafts OPCAB, robotic, connected 
>etc.
>
>As we all know patients in general do not want that big operation with
>stopped heart etc. OPCAB pr se was just one step on the way towards a fully 
>arterial
>revasc. off pump with a small incision.
>Then we can compete very well and do   a great job for the patient at the
>same time.
>  Does anybody on the forum really believe that ONCAB is actually better 
>than
>OPCAB?
>
>Jacob Bergsland
>
>
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