VISAYAS COMMUNITY MEDICAL CENTER

Department of Internal Medicine

Osmena Blvd., Cebu City

 

CONTNUING MEDICAL EDUCATION (CME) LECTURE

 

PRESENTOR:  Dr. Michael Tabaloc                            VENUE: VCMC Conference Room

ACTIVITY:     Consultant’s Lecture                            DATE & TIME: November 27, 2009, 8:30 A.M.

 

TOPIC: Multi-vessel Coronary Artery Revascularization

Coronary Artery By-pass Graft (CABG) still remains the gold standard for revascularization. The choice of CABG over Percutaneous Coronary Intervention (PCI) is generally preferred on multi-vessel diseases over single vessel diseases.

In the advent of technology and in the development of bare metal stents (BMS) and drug eluting stents (DES). Many studies have now focused on the comparison on the outcome of PCI against CABG which have a trend to have a favourable result towards PCI.

This lecture aims to discuss the following issues:

§    Are CABG and PCI complimentary?

§    Is the safety and efficacy similar?

§    Do cardiologists ‘cherry pick’ the  complex PCI cases? And also be the   ‘judge and jury’ in the referral process?

§    Do patients really receive informed consent for PCI procedures

        

WHAT IS NOT KNOWN on DRUNG ELUTING TENTS?

§    Which vessel should be done first?

§    When to do complete or incomplete revascularization?

§    How to decide – 1 or 2 sessions (staging)?

§    What is the late stent thrombosis risks?

§    Long-term outcomes are unknown

§    Clinical outcomes compared with CABG?

 

 

 

 

 

 

 

VISAYAS COMMUNITY MEDICAL CENTER

Department of Internal Medicine

Osmena Blvd., Cebu City

 

M I N U T E S:

CONTNUING MEDICAL EDUCATION (CME) LECTURE

 

PRESENTOR:  Dr. Michael Tabaloc                            VENUE: VCMC Conference Room

ACTIVITY:     Consultant’s Lecture                            DATE & TIME: November 27, 2009, 8:30 A.M

 

TOPIC: Multi-vessel Coronary Artery Revascularization

 

Time started: 8:40am

Time ended 9:40am

Attendance: 41 (residents, PGI’s and consultant)

 

Issues discussed:

·         The first question was on the cost of stent. The speaker said that a DES costs more or less P150,000 and each procedure would cost upto P450,000 for a single vessel disease.

·         The choice of DES over BMS is due to the high recurrence rate of stenosis.

·         The rate of BMS is still being used because BMS costs only P50,000 and it can still be used in bigger vessels.

·         The patient is always appraised of a possible CABG should PCI fail.

·         Both patients pst CABG and PCI are placed on aspirin for life

·         Clopidogrel is given on top of aspirin from 6 months to 1 year for patients post PCI.