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

[Tohru Asai]

Hal
Agreed except one condition. A certain group of patients seems have
depression with inappropriate multiple PCI or longstanding poor management
of CHF. So I see patients carefully and decide to do or not especially in
elderly group.
-- 
Tohru Asai
.




> Ed and Michael,
>   I'm a big believer in offering heart surgery to the right old  people.
> Just this week, I did a mini-AVR on a 91 yo lady and a AVR, mitral  repair on
> an 
> 87 yo man with multiple patent grafts.  Both are doing quite  well.  In fact,
> the 87 yo man was sitting in the chair on morning of  POD#1.  The first thing
> he did when I walked in was offer me his hand and  thank me for being his
> doctor and taking a chance on him.  Yes, these  patients are more frail with
> more 
> comorbidities, and the margin of error is  often razor thin.  However, I find
> the key is offering surgery to oldsters  who still have a zest for life.  The
> 91 yo lady still drove and lived alone  just prior to surgery.  The 87 yo man
> was cheerful every single time  I've spoke to him.  That's half the battle.
> In contrast, don't offer  high risk surgery to a old patient who is completely
> sedentary, depressed, with  no family support.
>  
> Hal