Maybe I am naive and not a deep thinker, but I am not worried one bit about AI claiming my cardiac surgery job or that of the generation that follows me. I am extremely worried, however, about the dismantling of the standards that lead to credentialing and promotion in my field.

You must have had the privilege over those past 25 years of working with exceptional surgeons who make a CABG look simple. It isn’t.

I think it is a matter of time before someone creates an AI enhanced video of a procedure and successfully submits it to a meeting for presentation.

Another rare case from the recent past. Chronically trapped Sapien TAVI in the aortic arch, removed under DHCA. Patient with months of TIAs pre op, complete resolution after removal.

The redo arch (with previous ascending replacement) feels to me technically easier than a virgin sternotomy total arch replacement. It almost seems that the graft originally placed pulls down the entire arch bringing the arch vessels closer to the operative field. Any opinions?

These studies remind me of tobacco company-sponsored studies in the 1950s that showed no early mortality differences between smokers and non-smokers.

20 years old but so relevant today… journals.plos.org/plosmedicine/a…

My point was not that this data is inaccurate but rather that the @nejm is basically publishing a study stating something along the lines that the roadworthiness of a Land Rover and a Toyota Corolla is the same 7 years after the two vehicles were purchased.

If a dual stage venous cannula cost $35,000 instead of $35, what would the CABG literature look like today?

This is one of the most amazing cardiac /aortic textbooks ever published. Discontinued a long time ago. Phenomenal drawings and angiogram stills from the pre CT era. If you are fortunate enough to have it, guard it like a treasure.

Over 370 pictures of this

Thank you for your support Wafik S. El-Deiry, MD, PhD, FACP and for the honor of your friendship!

The best treatment for afib remains elusive. Congratulations to the authors on a great study free of biases and fanfare.

I recently did one of the toughest (re) operations in my 23 year career : a CABG on a patient who underwent pericardiectomy 20 years ago. STS score 0.88%. Risk adjustment is a well intended strategy which disincentivizes surgeons from offering their skills to patients in need.

As painful as it may be for many “westerners” (myself not included), the father of CABG is Soviet surgeon Vasily Kolesov, a Great Patriotic War hero from Leningrad. This does not diminish the contributions of DeBakey, Cooley and Favaloro who popularized CABG in the modern era.

I guess cardiac surgery and the Maury Povich show The Maury Show have a lot of similarities.

For the history buffs, the contribution of Soviet physicians in medicine is immense, yet it was systemically suppressed from the free world, with the aid of their own system which kept many dissidents in the margins of Soviet society.

In my opinion the main barrier today is the quality of the meetings/publications and the selection criteria for the speakers combined with their conflicts of interest more so than any language barrier. A truly sad state of affairs for our field.

At our local Peterson School of the trades in MA it costs $10,950 for the 550 hrs (1-2 years) to become a licensed plumber. One can start at age 20 and by age 30 could be earning north of $300K/year. No threat from AI in the foreseeable future. In medicine we are eating our own.

Why does it cost in the US $350,000 to get an undergraduate degree added to $400,000+ to get a medical degree? Why have years of research between school/training become mandatory forcing doctors to start practicing in their mid/late thirties and accumulate debt up to that point?