Robotic Heart Surgery Needs a Pragmatic Visionary

Two reasonable assumptions gave birth to the field of robotic heart surgery. First, patients don’t want their incisions to be any larger than is necessary for a surgical procedure to be performed safely. Second, a surgical robot makes it feasible to perform a technically demanding procedure like heart surgery through small incisions. Propelled by these […]

Share the Decision to Avoid Regret

Sometimes there is only one appropriate treatment option for a patient. Consider someone with a knife stuck in their carotid artery. Nothing other than surgery is discussed. Many clinical problems aren’t like this and can be addressed by several different options with roughly equivalent outcomes. The choice of available options is “preference sensitive”, meaning that […]

What if Stroke after CABG was a “Never Event”

Heart surgery in the early days (1970’s) was a very dangerous proposition. The heart lung machines were rudimentary, with risks of complications were dramatic. Coronary bypass, the most common operation then as it is now, at most programs had a stroke risk that was around 5-10%. Improvements in preoperative risk stratification, perfusion strategies, and operative […]

The Complex Story of Pain with Less Invasive Surgery

It is self-evident that less invasive surgery reduces trauma to the body’s tissues compared to conventional open chest surgery. Tissue damage is what triggers pain as patients recover from surgery, so it logically follows that less invasive techniques reduce pain. Published results about less invasive surgery in every field – cardiac, thoracic, general surgery, urology, […]

Leading a Surgical Team Through Crisis

Heart surgery programs have their ups and downs. An “up” is the indescribable thrill when cases are coming out of the OR with no complications, require no blood products for bleeding and get out of the hospital quickly. A “down” is the times that patients get into complications. Even top performing programs have a rate […]