Re: [asa] occluders and stents

You are correct about the difficulty of obtaining good data on medical procedures.

As nifty as the septal occluder is, a cardiologist friend of mine calls it a "device in search of an indication."
  ----- Original Message -----
  From: Randy Isaac
  To: asa@calvin.edu
  Sent: Saturday, June 30, 2007 12:13 PM
  Subject: [asa] occluders and stents

  Hello, everyone,

      I think my heart may be strong enough again to cope with all your emails! It's been quite an experience. I can't compain about the views I had from the hospital room. From the 11th floor of MGH, there's a great view to the west of the Charles River, the Longfellow bridge, Cambridge, and the MIT campus.

      The cardiac catheter lab at MGH took care of two potentially serious problems in my heart. The primary purpose was to close the hole, known as a PFO, in my heart which should have closed shortly after birth. The doctors inserted an occluder of which there is a fascinating video clip at http://www.amplatzer.com/products/asd_devices/the_amplatzer_septal_occluder.html
  This is a superb application of the wonderful material nitinol. One might say that nitinol and polyester are the modern version of baling wire and duct tape.

      While looking around at my heart, they discovered an unexpected 60% blockage of the proximal left anterior descending artery. They took the opportunity to insert one of the drug-eluting stents that have been so controversially discussed in the news lately. http://www.fda.gov/cdrh/mda/docs/p030025.html

      This way I received two treatments (for the 'price' of one) of what might have been major problems in the future. I'm on a very restricted activity list for the next six weeks to ensure these devices don't move until the tissue grows to lock them in.

      This experience certainly gave me direct personal insight into the problems of obtaining good data on medical procedures. The stent debate that shook up interventional cardiology in the last six months is quite fascinating. Often it takes a long time and a large database to sort out the real consequences. Meanwhile decisions have to be made about treatment long before such studies can be done.

      Thanks again for your prayers, notes, and support.

      Randy

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Received on Sun Jul 1 07:34:36 2007