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

[Michael Firstenberg]

I think our Cardiologists - like those in many major centers (particularly
those who perform transplants, VADs, etc) probably get some sense of the
problem (emphasis on some.... since we still see it) since they are the ones
who get these patients emergently in the cath lab or who show up on their
service and we say there is nothing to do (anymore).......


-michael


On 2/9/08, Hgrmd at aol.com <Hgrmd at aol.com> wrote:
>
> Michael,
> One of the things I remember from the STS was from the Cleveland  Clinic
> in
> which their conclusion was that redo CABG was generally not warranted  if
> there was a patent LIMA to the LAD.  Extending that general theme, I  hope
> that
> one day the medical community will one day realize that most patients  do
> better with a LIMA to the LAD rather than PCI for proximal LAD disease.
> I suspect
> we would have a better chance of winning that battle with  MIDCAB's.
> Robotically assisted takedown of the LIMA is already a  reality.  Perhaps
> with the
> Cardica distal anastomotic device, it can  routinely be down
> endoscopically.
> However, I will say I heard a couple of  private comments that this device
> may
> have its problems.  I want to see  more long term data before I really
> take the
> plunge with this device.
> Rather than lament that cardiologists and patients don't want to  have
> their chest split to install a mammary and 3 veins, we should show
> them  that we
> truly have a better minimally invasive alternative to construct a LIMA  to
> the
> LAD.  Certainly, in your poor patient's case, he would have had a  better
> chance of survival.
>
> Hal
>
>
>
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