[HSF] Viability test

[Tea Acuff]

What viability test? 

I believe the (either cardiologists) analysis is too simplistic. Not necessarily wrong, but too simplicistic.

tea


----- Original Message ----
From: "zzhoumd at pol.net" <zzhoumd at pol.net>
To: OpenHeart-L at lists.hsforum.com
Sent: Saturday, January 12, 2008 9:46:10 PM
Subject: [HSF] Viability test


I saw two young patients recently for severe three vessel disease with low ejection fraction. One 48 y/o patient came to the hospital for chest pain, with EKG changes pain resolved with nitro and beta blocker cath show severe three vessel disease with goog targets. Cardiologist initially called me then decided to send him for viability study which show no reversible ischemia. So he sent the patient for transplant.

Today I saw another patient with EF 25% with good targets and admitted for same reason (non q-wave MI). This patient is only 38 year old and already on tranplant list because the viability test show no reversible ischemia. But this time a different cardiologist feel that we should offer him CABG before we send him for a transplant consult. 

It is obvious that both patients have ischemic myocardium otherwise they should not have MI.

Any comments? How much you do rely on viability study.

Z Zhou


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