[HSF] Too scared to touch.....

[bbiocina at kbd.hr]

Just to spice  the discussion , an anecdote from Croatia:
a private hospital , but contracted to the state insurance (therefore
motivated to do as many cases as possible) persistently declares ( on
the web) for years   a very large share ( up to 60%) of emergent CABGs,
vast amount of them are left mains or tripple vessel  disease , unstable
, of course. It is little odd , because it is located  in a spa in a
rural area , far far away from  big ( city-based) CCUs. In the other
hand , all of us  in state hospitals ( city-based , close  to CCUs) 
have the emergent  CABG rate well below 10 % , as left main patients ,
unless unstable , wait  for long time . I am telling that  just to show 
that  practices  may be  driven not only by medical , but also by
paramedical  parameters( not  necessarily financial , but habitual ,
availability related , etc.etc.).My UK experience  from 15 y  ago is the
same  as Ani's.
Bojan

On 5/2/2007, "psimha" <prasannasimha at gmail.com> wrote:

>There is no evidence base for stable left main. Only for unstable left
>main to be specific.(The Canadian study some years back seemed to
>expound it elegantly)
>Prasanna
>Ani Anyanwu wrote:
>> What is the evidence base for emergent revasularization of Left Main? When I worked in England few years back we had patients with Left Main on the waiting list for surgery for as long as a year.
>>
>> ANi