[HSF] Changing field in Our specialty

Sun Nov 1 20:10:56 EST 2009

What is CAS ?
Prasanna

On Sun, Nov 1, 2009 at 7:29 PM,  <hgrmd at aol.com> wrote:
> John,
>  Hopefully, the Feds and the providers will keep them in check.  They've done that with CAS.
>
> Hal
> Sent from my Verizon Wireless BlackBerry
>
> -----Original Message-----
> From: John Schor <johnschor at mac.com>
> Date: Sun, 01 Nov 2009 05:57:41
> To: <OpenHeart-L at lists.hsforum.com>
> Subject: Re: [HSF] Changing field in Our specialty
>
> I agree with Hal about suboptimal results with some of these
> disruptive technologies, BUT, the train is rolling. As we all know,
> patient flow is controlled by the cardiologists, and 99% believe that
> surgery is bad and catheters are good.
> John
> John Schor, MD
> Thoracic and Cardiovascular Surgery
> Heart and Vascular Center of
> Northern Arizona
> Flagstaff, Sedona, and
> Cottonwood, AZ
> Tel: 928-649-2584
>
> On Nov 1, 2009, at 4:37 AM, Hgrmd at aol.com wrote:
>
>> John,
>>  Agree it will be a "scary ride", mainly for the patients as some of
>> those technqies you describe give them clearly suboptimal results.
>> I strongly suspect the doc at TCT doing the ostial LM stenting with
>> a "perfect" result would be getting conventional LIMA to LAD if he
>> had the same anatomy.  I won't even begin to tell you my thoughts of
>> an E Valve clip and a c.s. Screwing up the anatomy of a repairable
>> valve.
>>
>>
>>
>>
>> Hal
>> Sent from my Verizon Wireless BlackBerry
>>
>> -----Original Message-----
>> From: John Schor <johnschor at mac.com>
>> Date: Sat, 31 Oct 2009 21:18:51
>> To: <OpenHeart-L at lists.hsforum.com>
>> Subject: Re: [HSF] Changing field in Our specialty
>>
>> In thoracic cases, the same size criteria is used for stent grafting
>> as for open surgery.
>>
>> I have believed for the past 9 yrs that "open surgery" would be
>> relegated to history books. As doctors( not just as CV surgeons), we
>> should be prepared for  1. repairs (of all organ systems) rather than
>> replacements 2. Avoidance of incisions--or increased use of scopes--
>> whenever possible 3. Natural Orifice access surgery 4. Medication
>> rather than surgery.
>>
>> The aorta, from the sinotubular junction to the bifurcation, will be
>> "fixed" with endovascular techniques. (probably in less than 10 yrs)
>> Agree with Tom. Even in my small community hospital working alone in
>> the OR (no PA or first assistants), I have been able to fix 10cm
>> ruptured AAA with stent grafting.
>>
>> You should all attend a Cardiology meeting such as the TCT. You will
>> be amazed to see such things as L Main stenting for 95% ostial
>> lesion--
>> with PERFECT result. Transfemoral and transapical AVR's done safely.
>> MV repairs with clips and then reinforced with coronary sinus
>> rings........
>>
>> Hold on to your hats. It's gonna be a scary ride.
>>
>> John
>>
>> John Schor, MD
>> Thoracic and Cardiovascular Surgery
>> Heart and Vascular Center of
>> Northern Arizona
>> Flagstaff, Sedona, and
>> Cottonwood, AZ
>> Tel: 928-649-2584
>>
>> On Oct 31, 2009, at 2:49 PM, Zhandong Zhou wrote:
>>
>>> What is your threshold for intervention, i mean the size for
>>> descending aorta.
>>>
>>> Zhandong Zhou, MD
>>> St. Joseph Hospital
>>> Syracuse, New York
>>> Tel: 315 423 7192
>>>
>>> On Oct 31, 2009, at 5:30 PM, John Schor <johnschor at mac.com> wrote:
>>>
>>>> Agree.
>>>> See many of my previous posts.
>>>> John
>>>> John Schor, MD
>>>> Thoracic and Cardiovascular Surgery
>>>> Heart and Vascular Center of
>>>> Northern Arizona
>>>> Flagstaff, Sedona, and
>>>> Cottonwood, AZ
>>>> Tel: 928-649-2584
>>>>
>>>> On Oct 31, 2009, at 11:02 AM, Zhandong Zhou wrote:
>>>>
>>>>> To all,
>>>>>
>>>>> I am in DC for a endovascular course for thoracic aneurysm. Only
>>>>> 25% are CV surgeons. Others are vascular, radiology, cardiologist.
>>>>>
>>>>> We need to catch up, without these skills, we are going to lose
>>>>> the percutaneous valve.
>>>>>
>>>>> Any thoughts?
>>>>>
>>>>> Z Zhou_______________________________________________
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-- 
Prasanna Simha M