AW: [HSF] Aortic Valve Stenosis and Carotid Stenosis

[erdinç naseri]

Ani and others,
It ıs very interesting that with more than one big RCT !( NASCE,ACAS,ESCT,ACE) in our pocket of knowledge we as memebrs of HSF couldn't even come near to an agreement on the treatment indications and guidlines of asymptomatic carotid artery stenosis.Some advocated operating any stenosis of carotid of more than 60% ( because the other specialties are doing that way) and some not operrate for stenosis of >80%.Does EBV really matter in everyday real life?
erdinc
 
 
 
 
 > From: anianyanwu at hotmail.com> To: openheart-l at lists.hsforum.com> Subject: RE: AW: [HSF] Aortic Valve Stenosis and Carotid Stenosis> Date: Tue, 29 Jan 2008 14:25:50 +0000> > I do not have the talk in written format yet. Basically my tenet was that as cardiac surgeons we will miss out if we keep focusing on evidence (that CABG is superior to PCI) as the tenet for survival of our speciality. I essentially went through what makes patients and doctors make the choices they do and demonstrated that evidence has little to do with the decisions made by patients, physicians or surgeons. To survive as a speciality we need to recreate ourselves to make surgery a desirable option within the framework of human decision making. > > As a simple example, the epidemic of unhealthy food or smoking or obesity has little to do with the lack of knowledge, evidence or information on their harmful effects- even with abundance of information, we still make choices that are not in our best interest (like french fries, smoking - and in the present discussion, i would argue, screening and surgery for asymptomatic disease or, as in the example Don reminded me of, my refusing to take rabies prophylaxis after a stray dog bite). People smoke, eat french fries or screen for asymptomatic disease because they derive immediate utility from it (in first instance the immediate satisfaction of smoking or eating, in the latter the satisfaction of believing one is healthy or can live forever), regardless of what the long term impact may be (atherosclerotic disease in former, possible inappropriate therapy, harm form medical therapy, pain associated with surgery, psychological trauma etc in the latter). > > I would hope one day I could debate David Taggart on this as my view differs diametrically from his.> > As regards how I prove this, like I said previously there are abundance of data if only we cared to study or read it - most who do so critically will likely come to the same conclusion as I would. Unfortunately we have selective perception, so tend to see what we want to see as surgeons, while blatantly ignoring logic or evidence that stares everyone else in the face, a tendency which Ajit aptly described some weeks back as 'surgical deafness'. > > Ani> > > > > > From: battr at medizin.uni-leipzig.de> To: OpenHeart-L at lists.hsforum.com> Subject: AW: [HSF] Aortic Valve Stenosis and Carotid Stenosis> Date: Tue, 29 Jan 2008 15:02:25 +0100> CC: > > > Ani,> I agree with you, but instinctively, how can you proof that?> Please, post the talk in HSF.> Roberto> > -----Ursprüngliche Nachricht-----> Von: openheart-l-bounces at lists.hsforum.com> [mailto:openheart-l-bounces at lists.hsforum.com] Im Auftrag von> wftjrtyler at aol.com> Gesendet: Dienstag, 29. Januar 2008 00:44> An: OpenHeart-L at lists.hsforum.com> Betreff: Re: [HSF] Aortic Valve Stenosis and Carotid Stenosis> > Ani, I would thoroughly enjoy reading the text (if such exists) of this > lecture. bill turner> > > In a message dated 1/28/2008 12:08:25 P.M. Central Standard Time, > msfirst at gmail.com writes:> > gave a lecture 3 weeks ago on medical decision making which I could share > over time but many of the ways we interpet data and events are biased by> strong > psychological biases> > > > > **************Start the year off right. Easy ways to stay in shape. > http://body.aol.com/fitness/winter-exercise?NCID=aolcmp00300000002489> _______________________________________________> OpenHeart-L mailing list> > Send postings to:> OpenHeart-L at lists.hsforum.com> > To UNSUBSCRIBE, to CHANGE email address, or to view archives:> http://mmp.cjp.com/mailman/listinfo/openheart-l> > All messages transmitted by the OpenHeart-L are subject to the policies and > disclaimers posted at:> http://www.hsforum.com/listdisclaim> -----------------------------------------> > _______________________________________________> OpenHeart-L mailing list> > Send postings to:> OpenHeart-L at lists.hsforum.com> > To UNSUBSCRIBE, to CHANGE email address, or to view archives:> http://mmp.cjp.com/mailman/listinfo/openheart-l> > All messages transmitted by the OpenHeart-L are subject to the policies and > disclaimers posted at:> http://www.hsforum.com/listdisclaim> -----------------------------------------> _________________________________________________________________> Who's friends with who and co-starred in what?> http://www.searchgamesbox.com/celebrityseparation.shtml_______________________________________________> OpenHeart-L mailing list> > Send postings to:> OpenHeart-L at lists.hsforum.com> > To UNSUBSCRIBE, to CHANGE email address, or to view archives:> http://mmp.cjp.com/mailman/listinfo/openheart-l> > All messages transmitted by the OpenHeart-L are subject to the policies and > disclaimers posted at:> http://www.hsforum.com/listdisclaim> -----------------------------------------