CardioExchange Archive

November 13th, 2009

Genetic Testing in Unexplained Thrombosis – Part II

thomasmorgan and Richard A. Lange, MD, MBA

An expert weighs in on a case of unexplained VTE in a patient under 50. (see Part I)   The rationale for genetic testing in unexplained thrombosis is to gain a better understanding of why VTE occurred and to document risk factors for recurrent events. However, genetic testing in this setting is somewhat controversial. Knowing […]

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November 12th, 2009

Renal Artery Stenting NOT Beneficial

Richard A. Lange, MD, MBA

In patients with atherosclerotic renovascular disease, renal artery stenting carries no benefit when compared to medical therapy, but stenting does carry a substantial risk.  In a recently published study, 806 patients were randomly assigned to undergo revascularization (almost exclusively done with stenting) in addition to medications or to medications alone (i.e, statin, antiplatelet agents, and […]

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November 4th, 2009

Have We Been Off Track With Off-Pump CABG?

Richard A. Lange, MD, MBA

Off-pump CABG has been heralded as being superior to on-pump CABG, with the contention that it reduces the occurrence of the dreaded complications of cardiopulmonary bypass (stroke and neurocognitive deficits) and utilizes fewer medical resources.  However, the data supporting this contention are scant.   Now, a large randomized study of off-pump versus on-pump CABG in […]

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November 3rd, 2009

Does coronary revascularization make noncardiac surgery safer?

Richard A. Lange, MD, MBA

Does coronary revascularization make noncardiac surgery safer?  If so, when?   On the cardiology consult service today, we evaluated a man who needs a “low risk” gastrointestinal surgical procedure urgently.  He presented to hospital admission with a prolonged hypotensive episode associated with anterior ST depression and mildly elevated troponin levels and without chest pain. He had […]

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