[HSF] Bob Frater-OT

Tue Mar 20 16:26:59 EDT 2007

Funny thoughts came after reading these messages. As we are wrapping the day
here keep in mind the time differences. My chief used to say "don’t
compromise, compromise is the mother of complication and she does not
practice birth control" 
He meant one complications leads to another and so forth

Ahmed

-----Original Message-----
From: openheart-l-bounces at lists.hsforum.com
[mailto:openheart-l-bounces at lists.hsforum.com] On Behalf Of Dr. Roberto
Battellini
Sent: Tuesday, March 20, 2007 4:15 AM
To: OpenHeart-L at lists.hsforum.com
Subject: AW: [HSF] Bob Frater-OT

Bob, when you finish writing your memories, please send me a copy.
Many times I archive your thoughts in "Pearls" archive I have.
Roberto

-----Ursprüngliche Nachricht-----
Von: openheart-l-bounces at lists.hsforum.com
[mailto:openheart-l-bounces at lists.hsforum.com] Im Auftrag von
rwmfglycar at aol.com
Gesendet: Montag, 19. März 2007 22:47
An: OpenHeart-L at lists.hsforum.com
Betreff: Re: [HSF] IE

Many thanks and carry on the way you are going and remember the day you
allow yourself to think, "Now I've got it"  be doubly careful,
Good luck,
Bob

-----Original Message-----
From: msfirst at gmail.com
To: OpenHeart-L at lists.hsforum.com
Sent: Sun, 18 Mar 2007 8:13 PM
Subject: Re: [HSF] IE

Bob, 
I would have very much cherished the opportunity to work with you. 

-michael 

On Mar 18, 2007, at 4:13 PM, rwmfglycar at aol.com wrote: 

> Dear Michael, 
> We all have been through this. Believe me I have seen world > renowned
figures suddenly up to their necks in it., and not getting > out of it with
the cameras rolling. A conscious goal of mine in > teaching was to ensure
that NO resident ever made one of those > mistakes. This meant conscious
awareness of the exact circumstance > that got you or someone else into
trouble in the past and the exact > maneuver that you had determined would
avoid this accident. And > this means, as Prasanna describes, repeating the
same old story > time and time again, 
> Bob 
> 
> -----Original Message----- 
> From: msfirst at gmail.com 
> To: OpenHeart-L at lists.hsforum.com 
> Sent: Sun, 18 Mar 2007 12:15 PM 
> Subject: Re: [HSF] IE 
> 
> 
> I guess that is why the training for heart surgery is so long - to > learn
from mistakes in hopes of never repeating them (or at least > how to get out
of trouble). It is amazing how 1 simple move and > tiny mistake can turn
into a disaster. 
> 
> Yes, these are very painful lessons - as a young guy, many of these >
memories are fresh and that is why I dont rush things and try to be > very
deliberate and careful. 
> 
> -michael 
> 
> On Mar 18, 2007, at 12:02 PM, prasannasimha wrote: 
> 
>> Michael, you opened a can of worms. 
>> My first time I assisted an Open heart as second assistant during >> >
residency - MVR going on and my Boss (Remember never had held a >> > Cooley)
and he suddenly said "pull" and I pulled and part of the >> > IVC tore. That
will be very well stuck in my head. Including the >> > shouting and circus
that happened thereafter with me not > >> comprehending fully what was going
on !! 
>> My first open heart death - I was a resident doing an AVR on a old >> >
lady in her 70's with a butter heart. AVR uneventful and > >> decannulated
the heart and was ligating the fatty RA appendage >> when > it cut through -
attempts to obtain hemostasis led to >> extension of > the tear and into the
AV groove and to cut a long >> story short a CAB > to the RCA and a patient
who later died due to >> one faulty step. I > reiterate it every time I see
a fatty friable >> appendage to all the > Residents. 
>> Some of these stories stick for life. 
>> Prasanna 
>> Michael Firstenberg wrote: 
>>> I have learned (from others as I am still too young and green) >> >>>
that taking the time (in my case, much more than 30 minutes) that >>> >>
putting a ring in is worth the effort - problems dont go away >>> on >>
their own. While some MR gets better over time, they still >>> need >> to
make it out of the hospital and I have seen some long >>> post->> operative
stays in patients who didnt get their MR fixed >>> - and one >> has to
wonder what the path would be if the valve >>> was addressed. >> Obviously,
at times, easier said than done. >>> But, I have also >> seen some bad
problems from beating up on an >>> old fragile heart. I >> know of a case
where a surgeon avulsed an >>> old lady's heart from >> the IVC trying to
get exposure for a >>> mitral.... she didnt do too >> well. 
>>> 
>>> michael 
>>> 
>>> 
>>> On Mar 18, 2007, at 10:31 AM, Hgrmd at aol.com wrote: 
>>> 
>>>> Michael, 
>>>> In your case, maybe you shouldn't address the mitral valve, >>> >>>>
particularly 
>>>> if your attendings are going to anticoagulate for 3 months a >>> >>>>
patient with 
>>>> recent GI bleeding. For me, the limiting factor in your patient >>>>
>>> will be his 
>>>> mental status. If he's too demented, do an OPCAB or maybe >>> >>>>
nothing. As for the 
>>>> extra time for cannulation and manipulating a "fragile" heart, >>>> >>>
that's no big 
>>>> deal. Installing a ring for ischemic MR generally adds less >>> >>>>
than 1/2 hour to 
>>>> my clamp time. With experience, you'll eventually feel the same. 
>>>> Hal 
>>>> 
>>>> 
>>>> 
>>>> ************************************** AOL now offers free email >>>>
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>>>> Find out more about what's free from AOL at http://www.aol.com. 
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>>> 
>>> 
>> 
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