Topol and Teirstein: The Click and Rub Show

View all posts »

#10: What case for live cases?

Nov 14, 2011 09:35 EST


From the floor of the TCT convention center, Drs Eric Topol and Paul Teirstein ponder live cases: immoral grandstanding or important learning and treatment opportunity?

See also:

Dehmer GJ, Douglas JS, Abizaid A, et al. SCAI/ACCF/HRS/ESC/SOLACI/APSIC Statement on the Use of Live Case Demonstrations at Cardiology Meetings Assessments of the past and standards for the future. J Am Coll Cardiol, 2010; 56:1267-1282. Available here.

A script for the show: Live cases in cardiology get a code of conduct





« Previous Post
#11: Planes, mains, and flying machines
Feb 14, 2012 10:05 EST Next post »
#9: Behind the scenes of hospital ranking
Oct 4, 2011 15:50 EDT



Your comments
#10: What case for live cases?
# 1 of 2
November 14, 2011 08:11 (EST)
docsurya
Great discussion. Live cases are very informative, especially for fellows. I do like the archives from Mt. Sinai on theheart.org, it would be great to also watch cases from other places like your's - Scripps.
# 2 of 2
December 11, 2011 04:32 (EST)
Guy Wright-Smith

As a full time private practice cardiologist I have been to many live case meetings around the world. The overwhelming lesson I learn from these cases is what not to do!!

 

Often in lives cases equipment that has been around for 20 years gets pulled out and once again, and we are all told how good it is, i.e, IVUS, Roto, pressure wire. and that we don't use it enough etc, etc, etc.  99% of cases I do don't need IVUS, Roto, or pressure wire, but 100% of live cases use this stuff. It's like a broken record.

 

Often the operator has decided what to do already, they obtain the opinion of the panel and then do the exact opposite, the audience all groan, the result is as expected or worse, the operator justifies what he did saying that was the best option at the time.

 

I love live cases, but they can be a little condescending when talking to the audience. I know when a stent has been deployed in the proximal LAD with a 2.5mm balloon that it underdeployed, I don't need IVUS.

 

During an MI I do not IVUS the plaque after thrombectomy when flow has been restored at 0200 hours, just to remind myself what a ruptured plaque looks like. This has been suggested that it should be routine, this came out if a live case! And the whole panel all nodded their heads in agreemant!  Routine IVUS during and MI, give me a break.

 

Keep the live cases coming, keep them real, don't patronise the audience, we have all been doing angioplasty quite well for 20 years, (don't tell us how to suck eggs), don't use epuipment just because it is there, listen to the panel, if they suggest not treating  the lesion then leave it alone!! 

Keep up the Click and Rub, great listening!!

 

Cheers from Queensland, Australia. 

 

 

You must be a member (with full membership) to post a comment.
Already a member?
Enter your login information below:
 Remember me on this computer
Forgot your username and/or password?
        Login        
Enjoy all the benefits of theheart.org

With full membership, you can check out our educational and editorial content, search the site, receive our newsletters, join discussions, download slides and much more.

Membership is free!

    Join now for full access    
About the Click and Rub Show
theheart.org brings you a freewheeling and unconventional exchange on the latest cardiology news and events through the eyes of thought leaders Drs Eric Topol and Paul Teirstein from Scripps Translational Research Institute.

We value the diverse opinions of our readership (that includes you!) -- share your thoughts by writing them in the comments box at left and stay tuned for new shows, posted on a monthly basis.