New device study

 Starting a new study using an automated anastomotic device, the Cardica C Port Flex A (www.cardica.com), in robotically assisted coronary artery bypass operations. The C Port device produces a precise, consistent, compliant connection between two vessels.  In previous studies it has been shown to have results (graft patency) superior to hand sewn anastomoses.

We have been using these devices in both open coronary bypass procedures (mainly in off pump procedures) and some robotically assisted closed chest coronary bypasses for over a year now with good results (they have already gained FDA approval).  The purpose of the study is to document the results of using this technology in a closed chest setting.  So, although the basic procedure will not change from our current practice the follow up will include a cardiac CT scan at 2 weeks, then again at 9 months to document the result of using this technology.

Angina (Chest pain)

Angina: officially Angina Pectoris, from latin and greek meaning 'squeezing of the chest'.  Chest pain characteristic of ischemia (lack of blood and oxygen) to the heart muscle.  Frequently described as a tightness in the mid chest with radiation to the arm or neck.  The actual symptoms can vary  widely, and in fact many people (especially diabetics) can have 'silent' angina and have ischemia or even a heart attack and just feel 'bad', with no specific chest discomfort.  Angina is most often caused by a narrowing in one or more of the coronary arteries.  These vessels supply the blood to the heart muscle itself.  Prolonged lack of blood and oxygen to an area of heart muscle leads to the death of muscle cells (think permanent irreversible damage) = Heart Attack.

    Angina itself is not a heart attack.  The pain is usually relatively short in duration and with cessation of the inciting activity will subside and adequate perfusion to the involved heart muscle cells return.  Stable angina is characterized by a repeatable set of symptoms, typically chest discomfort that occurs with physical exertion and will be relievable with rest.  It may progress to occurring with less activity and in severe cases may even occur at rest or wake one from sleep.  Symptoms that are progressive are then referred to as "Unstable" angina.  Rest and especially nocturnal angina are most concerning since they frequently are characteristic of severe coronary artery disease.

      The important 'take away' is that any chest pain should not be ignored.  In the case of a heart attack "time is muscle' and the sooner attention is sought and perfusion restored to the heart muscle in jeopardy (via drugs or mechanical treatments) the less permanent damage occurs.

Have Heart (havhrt)

   Welcome.  In this blog I will try to decipher some of the confusion and controversy in the world of heart care.  I will attempt to explain, in layman's terms, what some common conditions are and review some of the available treatments.  In addition I will try to pass on some relevant cardiac medical news updates.  I will be glad to answer some factual questions but, for obvious reasons, cannot dispense personal medical advice in a forum such as this.  In that line, nothing in this blog should be considered as medical advice simply an adjunct to understanding the often confusing world of medical care.

    Some times I will give you an insight to the world of my cardiac surgical practice, obviously without compromising any specific patient confidentialities.  And from time to time may share some of my other passions, such as photography.