The Difficult Problem that is Aortic Dissection.

There is no other cardiothoracic procedure that is as challenging as the management of a patient with type A aortic dissection.
Untreated, the immediate mortality rate is 1% per hour.   The surgery to repair a type A dissection is extremely challenging, patients are very sick, and coagulopathic and the dissected vascular tissues are incredibly friable and difficult to work with. To make matters worse, the average on call surgeon dealing the majority of these cases will only operate on a very small number of aortovascular cases per year.  The operative mortality in most countries of the world for this procedure is around 25-30%.
I have come across this excellent video presented recently by the American Society of Thoracic Surgeons on some of the very difficult issues surrounding the operative management of these patients.
It is worth a share!

The surgeon with One thumb

Did you know that the Larry King has had a history cardiac disease and intervention and has contributed to cardiac medicine as a patient advocate. He was seen in recent days at the Annual American College of cardiology Shindig in San Francisco (tweet below) and introduced the recent annual meeting of the Society of Thoracic Surgeons in LA with an amusing story about a heart surgeon.

I'm at the American College of Cardiology's #ACC13 this AM - getting the first-ever patient advocate award bit.ly/ZreVmN
— Larry King(@kingsthings) March 9, 2013

What you can do with Clinical Data - the Gospel according to Tim Kelsey

STS Survival Calculator
This calculator is found on the website of the Society of Thoracic Surgeons, one of the 2 big professional Cardiothoracic Societies in the USA. With a few clinical variables, you can calculate the survival potential of any individual patient. It demonstrates the incredible things you can do with comprehensive clinical data. Tim Kelsey is the first National Director for Patients and Information in the National Health Service and sits on the NHS Commissioning Board. He is championing the comprehensive use of digital clinical data for the benefit of patients. 
In this video he talks about the liquidity (great term) of data and why and how the use of clinical data, which is already there in the ether/cloud will shape how the new NHS will develop. 

Tim Kelsey: A patient-centred NHS from Nuffield Trust on Vimeo.