GoREDTalk - Coronary Artery Disease.mp4
GoREDTalk - Coronary Artery Disease.mp4
This informative GoRED Talk features by Dr. Roland Assi, cardiac surgeon at the Heart and Vascular Center at Yale New Haven Health. Dr. Assi discusses prevention of coronary artery disease and when open heart surgery is necessary. The GoRED Talk series is presented by the Heart and Vascular Center at Yale New Haven Health.
Content
0.4 -> (light dramatic music)
14.4 -> - My name is Roland Assi.
16.23 -> I am a heart surgeon at Yale New Haven
18.3 -> Heart and Vascular Center,
20.04 -> and an assistant professor
21.3 -> at the Yale University School of Medicine.
24.06 -> I specialize in taking care of patients
26.1 -> with coronary artery disease,
27.93 -> which can be described
29.07 -> as a dangerous buildup
of plaque in the vessels
31.56 -> of the heart.
33.3 -> I see patients who are diagnosed
34.619 -> with advanced or complex
coronary artery disease.
37.459 -> These patients may present with
39.84 -> or without a heart attack or heart failure
42.57 -> for consideration of open
heart bypass surgery.
46.53 -> Heart attacks caused
48.15 -> by coronary artery disease
remain the most common cause
51.09 -> of death in the United States,
52.467 -> affecting over 700,000 people per year.
55.86 -> With such staggering numbers,
58.17 -> we must consider multiple
intervention strategies.
61.95 -> The data consistently tell
us that early prevention
64.92 -> and medical treatment of
coronary artery disease
67.211 -> either delay or even
prevent heart attacks.
71.1 -> Despite the promise of early intervention,
73.56 -> numerous patients require nonetheless
75.66 -> other approaches such as
percutaneous intervention,
78.877 -> also known as stent placement.
81.63 -> Or in other cases, open heart surgery.
84.759 -> Coronary artery bypass surgery,
86.549 -> or simply open heart bypass surgery,
89.97 -> is among the most important
surgical procedures
92.91 -> in the history of medicine.
94.15 -> This advancement has prolonged
and improved the lives
97.18 -> of hundreds of thousands of
patients since its beginning
100.65 -> in the 1960s.
102.42 -> The treatment and prevention
103.95 -> of coronary artery disease
improved significantly
106.79 -> with the widespread use
108.45 -> and access to medications
110.31 -> and percutaneous interventions.
111.94 -> As such, the role of
surgery has largely centered
115.62 -> on the care of patients
who present with advanced
118.14 -> and complex forms of disease
that are not amenable
121.41 -> to medical or percutaneous therapies.
124.01 -> There are multiple principles
for the care of patients
126.96 -> with complex or advanced
coronary artery disease.
129.42 -> The most important of which are,
132.66 -> first, the decision to offer
bypass surgery should be based
136.189 -> on the clinical indications regardless
138.78 -> of sex, race, or ethnicity
140.78 -> because there is no
evidence that some patients
143.046 -> benefit less than others.
145.41 -> With multiple refinement
146.67 -> and surgical technique and technology,
148.46 -> open heart bypass surgery has
become a safe procedure even
152.79 -> for patients with advanced disease.
155.13 -> Second, when compared to
percutaneous interventions,
158.61 -> bypass surgery provides
the best opportunity
161.49 -> for enhanced survival
162.78 -> and quality of life for patients
164.83 -> with complex coronary artery disease,
167.097 -> heart failure due to
weakened heart muscle,
170.04 -> or with diabetes.
172.5 -> Third, when the benefit
of surgery is uncertain,
175.65 -> patients may benefit from
a heart team approach.
179.46 -> A heart team is a multidisciplinary
collaborative team
182.24 -> of physicians that includes the patient's
184.86 -> general cardiologists,
186.39 -> interventional cardiologists,
and cardiac surgeon.
189.66 -> Fourth, different therapies
for coronary artery disease
193.02 -> are not mutually exclusive.
195.27 -> For complex cases,
196.56 -> some patients may benefit
from hybrid strategies
199.85 -> or the use of both percutaneous
and open bypass surgery
203.79 -> which we usually offer
in a stage approach.
206.51 -> This allows for a comprehensive treatment
208.619 -> that considers the
patient's surgical risk,
211.579 -> anatomical considerations
and enhances recovery.
216.06 -> Medical therapy and
risk factor modification
218.7 -> maintain an important role
220.41 -> in preventing recurrent disease
222.39 -> for many years following surgery.
224.5 -> To conclude, I would like
to emphasize the importance
227.18 -> of the direct involvement of the patient
229.59 -> in the informed decision making.
231.349 -> With a significant advancements
233.34 -> in all aspects of therapies
for heart disease,
236.22 -> physician can take into
account the particularities
238.77 -> and nuances related to each patient
241.65 -> and offer them a comprehensive
243.48 -> individualized treatment strategy
245.43 -> affording the most benefit
248.13 -> with the least amount of risk.
249.96 -> Thank you, and be well.
Source: https://www.youtube.com/watch?v=SXAFaBDvaWc