AW: AW: [HSF] Hybrid operating room

[alsadd]

Prasanna:

I can not say no to your request Prasanna. Take care

Ahmed

-----Original Message-----
From: openheart-l-bounces at lists.hsforum.com
[mailto:openheart-l-bounces at lists.hsforum.com] On Behalf Of psimha
Sent: Tuesday, November 06, 2007 4:07 AM
To: OpenHeart-L at lists.hsforum.com
Subject: Re: AW: AW: [HSF] Hybrid operating room

Better still on list - so that we can share your trials and 
tribulations. One day I may get a robot (or better still if I can 
indigenize an alternative - Ha Ha  wishful thinking but well you never 
know the evil processes that can lurk in the human mind !!) and then I 
would definitely be able to pick your brains from your experience.
Prasanna
alsadd wrote:
> Dear Z Zhou:
> Since we are in the process of starting a hybrid program in the near
future.
> I hope it would all right with you if you I email you directly off the
Forum
> for some specifics that may not interest to most of our friends in the
> Forum.
> Thank you 
>
> Ahmed
>
>
> -----Original Message-----
> From: openheart-l-bounces at lists.hsforum.com
> [mailto:openheart-l-bounces at lists.hsforum.com] On Behalf Of Zhandong Zhou
> Sent: Sunday, November 04, 2007 8:05 PM
> To: OpenHeart-L at lists.hsforum.com
> Subject: Re: AW: AW: [HSF] Hybrid operating room
>
> Dear Ani, 
>
> You raised a very good question. The hybrid operating room is mainly built
> for cardiovasucular procedures, i.e. vascular or cardiac surgery for stent
> graft. It is also necessary for endo valve and trans apical valve in the
> future. The rooms are usually bigger than existing room. If the equipments
> are not in the way of robotic instrument, we can use it for robotic cases
as
> other rooms are too small for robot.
>
> The idea of hybrid (some call intergrated) coronary revasculization is
based
> on the assumption that DES (drug eluting stent) is comparable to vein
graft,
> but not as good as LIMA. The data so far seems support that idea for type
A
> or B lesions. However, LIMA is the only graft has been shown with survival
> benefit, not DES. 
>
> Recently, our cardiologists are interested in doing hybrid procedures.
> Surgeons place the LIMA to LAD, then cardiologists stent the RCA and/or Cx
> if the lesion is type A or B. with Robot assisted IMA taken down, the
> surgery incision is only 5-6 cm. I can take down LIMA within one hour with
> Robot if the anatomy is favorable.
>
> I do not know what the future stands for this kind hybrid procedure. I
have
> done about 10 cases with our cardiologists. So far, patients are doing
very
> well. I do know Texas Heart has at least 3 hybrid operating rooms.
> University of Maryland has one. Vanderbelt has one now and they are
building
> 5 more hybrid rooms. Our robot is so booked up, I can only get one day per
> week and I do need more time. Our urologists have wating list for about 3
> months. Gyn and general surgery also use it for abdominal cases. 
>
> I wish I could come to your dinner meeting so we can have a debat about
> hybrid or none hybrid. Like many other professional services, cardiac
> surgery is a service. We, as a surgeon, provide all the services for our
> customers, i.e. cardiologist, primary care physicians and patients. Many
> times, the decision is handed to us, not made by us. With so many of us
> around, if you do not like it, someone else will do it.
>
> I attach a picture of a case I did a few weeks ago. Patient has LIMA to
LAD
> and Diag with a Y graft.
>
> Z Zhou
>
>
>
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