–Life-saving benefit of CABG now clear in long-term trial follow-up Finally, after 10 years of follow-up, the life-saving benefits of coronary artery bypass graft (CABG) surgery in heart failure patients with coronary artery disease are clear. More than 15 years ago, the NIH funded the original STICH trial to answer a question that was already…
Guideline Critics Shift Attacks From Beta Blockers To Statins
August 1, 2014 by Leave a Comment
With the release today of updated European and US guidelines the ongoing controversy regarding beta-blockers appears to be resolved. But that doesn’t necessarily mean there will be an outbreak of guideline peace and harmony. The critics who helped ignite the controversy over beta blockers now say new statin recommendations contained in the guidelines are based on deeply flawed evidence….
Tooth Extraction Prior to Cardiac Surgery May Not Be a Good Idea
February 27, 2014 by Leave a Comment
People with an infected or abscessed tooth are at elevated risk for cardiovascular disease. They are at particular risk for developing a serious infection during surgery, including endocarditis, a potentially life-threatening infection of the heart. Because of this risk, in order to reduce the chance of infection, many patients undergo dental extraction prior to having…
FDA Approves Abbot’s MitraClip For Patients At Prohibitive Surgical Risk
October 25, 2013 by Leave a Comment
The FDA today approved Abbott’s catheter-based MitraClip device for patients with significant symptomatic degenerative MR who are at prohibitive risk for mitral valve surgery. The company said it would launch the device immediately in the United States. The device is the first percutaneous nonsurgical therapy approved for the treatment of mitral valve disease. … Click here…
Surgery Preferable To Stents In Elderly People With Carotid Disease
October 23, 2013 by Leave a Comment
Age should play an important role in choosing a revascularization procedure for people with blocked carotid arteries, according to a new paper published in JAMA Surgery. Carotid endarterectomy surgery (CEA) is preferable to carotid artery stenting (CAS) in elderly people; for younger patients the two revascularization procedures are broadly similar. George Antoniou and colleagues analyzed data from 44…
Can Inflating A Blood Pressure Cuff Improve Outcomes Following Bypass Surgery?
August 15, 2013 by Leave a Comment
http://www.forbes.com/sites/larryhusten/2013/08/15/can-inflating-a-blood-pressure-cuff-improve-outcomes-following-bypass-surgery/ For several decades cardiologists have been intrigued by the concept of ischemic preconditioning. A small body of research has consistently found that brief episodes of ischemia (in which reduced blood flow results in damage to tissue) appeared to somehow prepare the body to better handle a major episode of ischemia. Now a new study…
Study Suggests Benefit For Beta Blockers During Noncardiac Surgery
April 23, 2013 by Leave a Comment
The use of perioperative beta-blockade for noncardiac surgery has been declining as a result of the controversial POISE study, which turned up evidence for harm associated with extended-release metoprolol in this setting. Now a large new observational study published in JAMA offers a contrary perspective by suggesting that perioperative beta-blockade may be beneficial in low-…
Are Most People With Complex Coronary Disease Getting The Best Treatment?
February 22, 2013 by 1 Comment
The relative value of PCI (stents) and bypass surgery for the treatment of people with blocked coronary arteries has been a topic of intense interest and debate for more than a generation now. Over time, the less invasive and more patient-friendly (and less scary) PCI has become the more popular procedure, but the surgeons (who…
The Best Doctor Blog On The Internet
January 25, 2013 by 3 Comments
Let me say it right away: the best blog written by a doctor, at least that I’ve ever read, is by a provincial South African general surgeon who calls himself Bongi. He doesn’t write about complex medical policy, and he doesn’t worry too much about appropriate use criteria or whether a patient who needs anticoagulation…
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