[HSF] Impact of previous PCI on outcomes after CABG

Wed Mar 26 18:24:03 EDT 2008

We as surgeons are are not just disinterested observers in all of this. We grumble among ourselves, but say little locally and are delighted to be on a consensus board with 20 cardiologist. What do you think of us surgeons?

tea

----- Original Message ----
From: "ichfno at aol.com" <ichfno at aol.com>
To: OpenHeart-L at lists.hsforum.com
Sent: Tuesday, March 25, 2008 10:59:25 PM
Subject: Re: [HSF] Impact of previous PCI on outcomes after CABG

Tea;

Forgive me but I am not sure exactly what you mean? As a previous combatant in the adult world I remember getting stent disasters sent from the cath lab. We were rarely consulted before the procedure by the cardiologist, "gee come take a look and give me an opinion before I do this", I doubt that has changed in the last 13 years. The public is maleable, sure they want the smaller incision, but at the cost of being on an umbilical cord to their cardiologists? I am not sure that they would all be that way, I think that some people actually think about long term ( whether that be 7 or 15 years) results when it comes to their coronary intervention, mind you this does not apply to preventative approaches. I love surgeons, would not be anything else, especially not an interventional cardiologist who would try to sell refrigerators to Eskimo's, but they outclass surgeons in leaps and bounds when it comes to marketing interventional cardiology as compared to
 surgeons marketing the Go
ld Standard. So, what do I think, I think WE (if you will allow that Imperative) were fat and happy, even after the original angioplasty techniques came out, and they were hungry and aggressive, and now they have mastered the technique of creating a better, a newer, an improved STENT, still the same, stent schment. Until they come up with a biologically compatible endothelially friendly stent WE have the Gold Standard, they have not proven anything except that in the short term their results are ALMOST as good as ours.

Bill 

-----Original Message-----
From: Tea Acuff <tacuff at swbell.net>
To: OpenHeart-L at lists.hsforum.com
Sent: Tue, 25 Mar 2008 8:53 pm
Subject: Re: [HSF] Impact of previous PCI on outcomes after CABG

So now we know what you think of patients. what's your opinion of surgeons? the 
same?

tea

----- Original Message ----
From: "ichfno at aol.com" <ichfno at aol.com>
To: OpenHeart-L at lists.hsforum.com
Sent: Tuesday, March 25, 2008 7:04:44 AM
Subject: Re: [HSF] Impact of previous PCI on outcomes after CABG

I think you would say where is the data showing it does not apply to DES? Some 
time you have to nail their fins to the floor, stent shment, it is a foreign 
object in the vascular space made of metal, only Plavix and all the other meds 
they use are what keep the DES ones open. Since the original angioplasty they 
have been out of control, moving targets, bending the data, looking at short 
term follow-up and calling it intermediate. I do not have to deal with these 
guys, but it still walks, talks and looks like a duck. Educate your patients, 
they will tell their friends and a referral friend to friend is the best. Not 
all patients are stupid.

Bill

-----Original Message-----
From: alsadd <alsadd at ksu.edu.sa>
To: OpenHeart-L at lists.hsforum.com
Sent: Tue, 25 Mar 2008 4:17 pm
Subject: RE: [HSF] Impact of previous PCI on outcomes after CABG

I am with you and was hoping to use it in the next meeting with our
cardiologists. As you would expect one of them "smart Alex" would stand up
and say that " it does not apply to DES; I rest my case" type of comments.
What would I say to that?

Ahmed

-----Original Message-----
From: openheart-l-bounces at lists.hsforum.com
[mailto:openheart-l-bounces at lists.hsforum.com] On Behalf Of Ben Bidstrup
Sent: Tuesday, March 25, 2008 2:04 AM
To: OpenHeart-L at lists.hsforum.com
Subject: RE: [HSF] Impact of previous PCI on outcomes after CABG

Devil's advocate.
What would the basis be for arguing a difference with  DES vs BMS?

>Ben:
>Thank you for this wonderful article. The only problem they are not sure if
>this applies to DES ?!  Look in the conclusion. I was dismayed to say the
>least
>
>
>Ahmed
>
>-----Original Message-----
>From: openheart-l-bounces at lists.hsforum.com
>[mailto:openheart-l-bounces at lists.hsforum.com] On Behalf Of Ben Bidstrup
>Sent: Monday, March 24, 2008 11:36 PM
>To: HS Forum
>Subject: [HSF] Impact of previous PCI on outcomes after CABG
>
>Readers might be (very) interested in this article.
>http://eurheartj.oxfordjournals.org/cgi/content/abstract/29/5/673
>
>Imagine that!
>--
>Ben Bidstrup FRACS FRCSEd FEBCTS
>Consultant Cardiothoracic Surgeon
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-- 
Ben Bidstrup FRACS FRCSEd FEBCTS
Consultant Cardiothoracic Surgeon
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