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

[Michael Firstenberg]

it ain't going to happen - there are plenty of papers showing good  
long-term (i.e. 1 year) outcomes with LAD/LM stents (of course as we  
are learning those patients would probably have just as good 1 yr  
MACE with medical therapy).


http://www.circ.ahajournals.org/cgi/content/abstract/116/11_suppl/I-232


-michael


On Feb 9, 2008, at 7:41 PM, Donald Ross wrote:

> Hal,
> Do you really think cardiologists are going to interrupt their  
> income stream just because we can graft the lad without a large  
> incision?
> They will need a big malpractice smack before they even consider  
> unbiased informed consent for lad stenting.
> Don
> On 10/02/2008, at 3:45 AM, 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
>>
>>
>>
>> **************Biggest Grammy Award surprises of all time on AOL  
>> Music.
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>> 48)
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