AW: [HSF] New crazy operations and solutions at HZL

[Ani Anyanwu]

> Yesterday Michael Borger and Thomas Walther did a transapical valve with> MIDCAB in a 87 year old lady with aortic stenosis and LAD stenosis.Today> extubated.
> Roberto
 
With respect, Roberto, while it is a feat that we can do such surgery and extubate the patient the same day, in the larger scheme of affairs that this patient is extubated means little in the context of success of her surgical operation. Unless this was a patient who was ventilator dependent beforehand, the fact that they are off a ventilator a day after surgery is not a marker of appropriateness or success of surgery. Similarly 30 day survival is not usually an appropriate marker of success of surgery, unless the disease was immediately life-threatening, such as for cardiogenic shock or aortic rupture. The vast majority of patients come to surgery alive and breathing without a ventilator so it is no success that they remain alive and off a ventilator a day after surgery.
 
To correlate from our experience, we recently looked at our results of MV repair for ischemic disease in octogenerians - like in your center we were able to extubate most patients on day 1 and send them away successfully with only 5% hospital mortality. Well is that a surgical feat? Maybe for the surgeons, but the patients might think differently. We looked at the one year survival, and guess what? Only 48% were alive a year after surgery. Again goes to illustrate how we as surgeons often wrongly ascribe success to our procedures because we measure the wrong indicators.
 
Ani
 



> From: battr at medizin.uni-leipzig.de> To: OpenHeart-L at lists.hsforum.com> Subject: AW: [HSF] New crazy operations and solutions at HZL> Date: Tue, 22 Apr 2008 17:23:44 +0200> CC: > > Yesterday Michael Borger and Thomas Walther did a transapical valve with> MIDCAB in a 87 year old lady with aortic stenosis and LAD stenosis.Today> extubated.> Crazy, but nice...this is the future in 10 years , do not forget.> It was clear, we have done more than 1200 MIDCABS ( I began in 1996) and> more than 100 transapical aortic replacements (I never did one) , now our> youngs begin to combine them.> Roberto> > > > > > All messages transmitted by the OpenHeart-L are subject to the policies and > disclaimers posted at:> http://www.hsforum.com/listdisclaim> -----------------------------------------> > _______________________________________________> OpenHeart-L mailing list> > Send postings to:> OpenHeart-L at lists.hsforum.com> > To UNSUBSCRIBE, to CHANGE email address, or to view archives:> http://mmp.cjp.com/mailman/listinfo/openheart-l> > All messages transmitted by the OpenHeart-L are subject to the policies and > disclaimers posted at:> http://www.hsforum.com/listdisclaim> -----------------------------------------
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