J Thorac Cardiovasc Surg 2008;136:27-28
© 2008 The American Association for Thoracic Surgery
Discussion
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Dr D. Craig Miller
(Stanford, Calif). I would like to welcome Chad Hughes to the Western Thoracic. If you keep doing this for 15 years in a row, like Walter Wolfe, we will make you an honorary member. It is nice to see the work from Duke come out west.
I want to compliment you for doing it right. You have a combined cardiothoracic and vascular surgical team in which the cardiothoracic surgeon is involved at the first step, the decision-making step, should anything be done regardless of whether it is endovascular or open. That is crucial, and I think that is the paramount difference between the indications we have seen today, which none of us would disagree with, and those we saw yesterday, in which a peripheral vascular surgeon is making that decision in a vacuum and perhaps patients are not being well served. You have done it right, and your results, albeit short term and small in number, are absolutely spectacular given the protoplasm you were dealing with.
My only question involves the grafts. They were Vascutek grafts, and I am still unclear whether they were custom fabricated for you or whether you made them at the back table, which is what we do. I would hope, since many of them are long tortuous small-caliber small-flow grafts, that these were Gelsoft or knitted grafts and not Gelweave or a woven graft or the Microvel Double Velour Hemashield (Boston Scientific Corporation, Natick, Mass)knitted compared with the woven grafts we have all learned that with low flow, a . . . [Full Text of this Article]
Copyright © 2008 by The American Association for Thoracic Surgery.
