[HSF] Another Victory for the LAD Stent.....

[Donald Ross]

Ani,
Would she have had cabg rather than a stent if she hadn't had any  
insurance?
This is sometimes the case in Australia where we have universal  
compulsory insurance for poorly funded pubic hospitals and private  
insurance for first rate private hospitals where cardiology practice  
is somewhat different.
Don
On 09/02/2008, at 9:01 AM, Ani Anyanwu wrote:

> Michael
>
> What did you do with the patient?
>
> Today saw a lady to evaluate for LVAD - she had bare metal stents  
> to RCA and LAD staged over two weeks in october 2007 (She did not  
> have drug eluting stents because her insurance company wont pay for  
> Plavix). At time of her angioplasty, her EF was 60%. She had an  
> acute MI in December due to occlusion of her LAD stent and now is  
> inotrope dependent with an EF of 15%. Cant have transplant because  
> of severe peripheral vascular disease, carotid disease, age.
>
> I suppose a two vessel CABG could have prevented this state of  
> affairs - who knows. How could we scientifically make this  
> determination?
>
> Ani
>
>
>
>
>> Date: Fri, 8 Feb 2008 10:51:26 -0500> From: msfirst at gmail.com> To:  
>> OpenHeart-L at lists.hsforum.com> CC: > Subject: [HSF] Another  
>> Victory for the LAD Stent.....> > All we know about this guy, we  
>> got from his driver's license.> > 59 year/old - called EMS from a  
>> local hotel with chest pain.> > Found in obvious respiratory  
>> distress with severe C.P.> Scooped and run to our ED - intubated  
>> in ED instantly, then taken to cath> lab...... very quick door to  
>> needle time.> > Cath - multiple LAD stents - occluded prox. unable  
>> to pass a wire> Circ - occluded, severe RCA disease> Has ICD> >  
>> tachycardic to 120-150's> mild hypotension> > echo in cath lab ---- 
>> > almost dead heart.> > severe pulm edema, severe respiratory  
>> acidosis (ph: 6.9 pCO2=90 sats in> 70's)> given lasix, heparin,  
>> reopro> > we are called........> > > > I guess he has not read the  
>> recent studies..............> > > > -michael>  
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