[HSF] Changing field in Our specialty-get on board or be left out

Sun Nov 1 16:33:44 EST 2009

The one which you were on CPB for 10 hours.Tell us more about it.
Prasanna

On Sun, Nov 1, 2009 at 4:00 PM, Michael Firstenberg <msfirst at gmail.com> wrote:
> Which one?
> The disaster endocarditis or the disaster thoracic pathology - or both the
> problems that no one wants because it is too much work?
>
> -michael/iPhone
>
> On Nov 1, 2009, at 1:09 AM, Dwight Hand <dwight_hand at hotmail.com> wrote:
>
>>
>> Michael,
>> Typical case in our region.
>> Dwight
>>
>>> From: msfirst at gmail.com
>>> To: OpenHeart-L at lists.hsforum.com
>>> Subject: Re: [HSF] Changing field in Our specialty-get on board or be
>>> left out
>>> Date: Sat, 31 Oct 2009 23:32:15 -0400
>>> CC:
>>>
>>> 10hrs on bypass?
>>> Regardless in my experience many of these patient have no doctors.
>>> They are always coming into the ED with chest pain poorly controlled
>>> hypertension whatever. Since the have descending pathology regardless
>>> of what else we always get called and no one else wants to claim
>>> ownership.
>>>
>>> Sure if you have a nice little boutique practice and get finely tuned
>>> patients sent to you then I am sure stenting can be fun.
>>>
>>> -michael/iPhone
>>>
>>> On Oct 31, 2009, at 11:06 PM, hgrmd at aol.com wrote:
>>>
>>>> Michael,
>>>> Sorry, just read your previous post.  Now I understand why you are
>>>> a bit cranky.  Sounds like you had a terrible case.
>>>>
>>>> Hal
>>>>
>>>> Hal
>>>> Sent from my Verizon Wireless BlackBerry
>>>>
>>>> -----Original Message-----
>>>> From: hgrmd at aol.com
>>>> Date: Sun, 1 Nov 2009 02:58:06
>>>> To: <OpenHeart-L at lists.hsforum.com>
>>>> Subject: Re: [HSF] Changing field in Our specialty-get on board or
>>>> be left out
>>>>
>>>> Michael,
>>>> Other than monitoring the result by CT and making sure the pt is on
>>>> the proper antihypertensive, doing a TEVAR doesn't make the surgeon
>>>> the pt's primary.  Certainly, I don't take that role with my cases.
>>>> Didn't get enough candy trick or treating tonight?
>>>>
>>>> Hal
>>>> Sent from my Verizon Wireless BlackBerry
>>>>
>>>> -----Original Message-----
>>>> From: Michael Firstenberg <msfirst at gmail.com>
>>>> Date: Sat, 31 Oct 2009 22:44:26
>>>> To: <OpenHeart-L at lists.hsforum.com>
>>>> Subject: Re: [HSF] Changing field in Our specialty-get on board or
>>>> be left out
>>>>
>>>> I have no problem giving up the descending stent graft work PROVIDED
>>>> whoever
>>>> does it takes care of these patients afterwards.  I find many of this
>>>> patients have horrible comorbidities, poorly controlled hypertension,
>>>> diabetes, etc that no one wants to deal with.  Many have not seen a
>>>> doctors
>>>> in years - if ever and rarely do they have insurance (not that I
>>>> care about
>>>> that).  If a Radiologist wants to put a stent graft in, then he/she
>>>> can take
>>>> responsibility for all of the patients other medical, social,
>>>> economic problems.  Knock yourselves out and good luck........
>>>>
>>>> Everyone wants to put the stent(s) in whatever vessel and walk away
>>>> - sorry,
>>>> doesnt work that way.........
>>>>
>>>> -michael
>>>>
>>>> On Sat, Oct 31, 2009 at 7:06 PM, <tdmartin2000 at aol.com> wrote:
>>>>
>>>>>
>>>>> My humble prediction
>>>>> Open descending and/or thoracoabdominal aortic aneurysm surgery is
>>>>> destined
>>>>> to the same fate as open gastric surgery or open gallbladder
>>>>> surgery within
>>>>> the next 10 yrs and those who don't get on board with endovascular
>>>>> methods
>>>>> will be left out.
>>>>>
>>>>> Tom Martin
>>>>> U of Florida
>>>>> Gainesville
>>>>>
>>>>> -----Original Message-----
>>>>> From: Igor Rudez <rudi at kbd.hr>
>>>>> To: OpenHeart-L at lists.hsforum.com
>>>>> Sent: Sat, Oct 31, 2009 6:31 pm
>>>>> Subject: RE: [HSF] Changing field in Our specialty
>>>>>
>>>>>
>>>>>
>>>>> Zhou,
>>>>> partially agree with you! Of course we have to master those (new)
>>>>> skills
>>>>> s well, but do not be afraid we are going to lose patients!
>>>>> can remember many of our colleagues were convinced that we're going
>>>>> to be
>>>>> ut of job because of drug eluting stents! And what happened?
>>>>> o, OK, yes, master the skills but no, we are still far, far in
>>>>> front of
>>>>> hem! And when they make a hole pushing some device, stent, whatever
>>>>> in the
>>>>> eart, aorta, wherever, who do you think they are going to call?
>>>>> Igor
>>>>> -----Original Message-----
>>>>> rom: openheart-l-bounces at lists.hsforum.com
>>>>> mailto:openheart-l-bounces at lists.hsforum.com] On Behalf Of Zhandong
>>>>> Zhou
>>>>> ent: Saturday, October 31, 2009 7:02 PM
>>>>> o: OpenHeart-L at lists.hsforum.com
>>>>> ubject: [HSF] Changing field in Our specialty
>>>>>
>>>>> o all,
>>>>> I am in DC for a endovascular course for thoracic aneurysm. Only 25%
>>>>> re CV surgeons. Others are vascular, radiology, cardiologist.
>>>>> We need to catch up, without these skills, we are going to lose the
>>>>> ercutaneous valve.
>>>>> Any thoughts?
>>>>> Z Zhou
>>>>>
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-- 
Prasanna Simha M