It was over a dozen years ago that I saw my first transradial PCI. I had booked a photo shoot with Dr. Felix Millhouse at Seton Medical Center in Daly City, California, to get some shots for our web site. I did one case and was told that Dr. Millhouse was doing an urgent PCI in cath lab #2. So I went over to shoot it, but by the time I got to the lab, I was too late. I saw a man with his arm extended off the table. And Dr. Millhouse was removing his gloves. “Sorry,” he said. “We’re all done.” Continue reading
I recently was rifling through some old files of news clippings (you remember those pesky things, don’t you?) and came across a major New York Times Magazine feature from 1983. It was titled, “Toward the Conquest of Heart Disease.”
Three decades ago, as the article describes, the main treatments were surgical: valve replacement and the “far more complicated, technically demanding” bypass graft surgery. The author, Harry Schwartz, also identifies some exciting new advances in heart disease treatment: artificial hearts, heart transplants, new drugs, something called nuclear magnetic resonance (N.M.R.) that was “being used in a handful of hospitals” (today we call it MRI!). Continue reading
If you’ve been wondering what iFR (Instant wave-Free Ratio) is, how it works, how it compares to FFR (Fractional Flow Reserve) and, most importantly, how it affects clinical outcomes, then click here to register for a free, online, interactive live case being done on Monday, April 13, 2:30pm-3:30pm London Time, 9:30am-10:30am New York Time).
Interactive: that means you can ask questions!
Dr. Justin E Davies, interventional cardiologist at Imperial College NHS Trust, and developer of iFR, will be performing and guiding the worldwide audience through a live complex PCI multivessel case, using physiology to guide his procedure. Continue reading
Consumer Reports regularly publishes health information to aid the consumer/patient in making decisions. And that’s a good thing. But also important is having the most current information, which their January 27, 2015 article, titled “The surprising dangers of CT scans and X-rays,” does not.
All of the cautions about imaging tests that are listed in the Consumer Reports article are valid: ask why the test is necessary; check the credentials of the imaging specialist; ask for the lowest effective dose; avoid unnecessary repeat scans.
But one important piece of data is almost a decade old and, as a result, is potentially misleading. I’m talking about the radiation dose from a Cardiac CT scan. The article states that a Cardiac CT Angiogram (CTA) exposes the patient to 12 mSv of ionizing radiation, or 120 times that of a chest X-ray. This was true years ago, when CTA was first being used to diagnose coronary artery disease. But it is not true today. Continue reading
Last week saw the U.S. Centers for Medicare and Medicaid Services (CMS) approve reimbursement for the two drug-coated balloons that recently were approved by the FDA: C. R. Bard’s Lutonix and Medtronic’s IN.PACT.
C. R. Bard’s Lutonix drug-coated balloon (DCB) was approved in October 2014, while Medtronic’s IN.PACT Admiral was approved in January of this year. Both devices have shown superior results when compared to uncoated balloons (a.k.a. “plain old balloon angioplasty” or POBA). Continue reading
The lyrics of the 1923 song go like this: “Who’s sorry now, who’s sorry now? / Whose heart is achin’ for breakin’ each vow?”
And today, it was the American Board of Internal Medicine (ABIM) who said they were sorry for breaking the hearts of all the cardiologists in the U.S. of A.
They wrote specifically: “We got it wrong and sincerely apologize. We are sorry.” Continue reading
Today’s the day that The National Board of Physicians and Surgeons (NBPAS) officially launches. Briefly stated, it’s an alternative certification organization, set up by Dr. Paul Teirstein and a group of physicians, mostly cardiologists, who strongly objected to the Maintenance of Certification assessment track established by the American Board of Internal Medicine (ABIM).
You can read more about it in my post from last week, “Scalpel…Suture…Suction…Pencil?” and in Dr. Teirstein’s New England Journal of Medicine article, titled “Boarded to Death — Why Maintenance of Certification Is Bad for Doctors and Patients.”
I’ll be following the progress of this initiative, but a few recent articles and developments bring up some interesting points. Continue reading