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'British Cardiovascular Society Blogging Cardiology'

When is an Op, not an Op! Shocking approach!

National Training Day session on Anaesthetics, Operations and ITU. Akhil Kapur talked us through the options for coronary revascularisation in patients who need other surgery and particularly major vascular surgery. Message seems to be that if you are low risk and stable, get on with the necessary surgery but investigate high risk patients and coronary revascularisation may be necessary. If known surgery on the horizon, bare metal stenting for PCI is the sensible option. Mark Gunning explained there were no managers at his cardio-renal clinic and pictures of Mont Blanc featured heavily, a lifetime away from “sunny” Manchester. Do not be frightened of renal dysfunction and important to recognise higher risk but also benefits of dealing with significant coronary disease. James Cotton made dealing with surgery in the post PCI patient seem easy (always the sign of a good talk) and dealing with anti-platelet therapy should take into account all the patient related factors carefully. Choose your surgeon and make informed sensible decisions based on risk of bleeding versus risk of ACS and stent thrombosis. Finally, recognising cardiogenic shock early and especially the underlying cause and managing reversible factors swiftly and effectively were the key messages from Susanna Price. All the talks from this session will be available on webcast at www.bcs.com for members following the Annual Conference & Exhibition.

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