Journal of Invasive Cardiology

Yeah, I know I stole the line from a Spider-Man comic!  But, recently an issue came up on one of the national committees I’m a part of, and it got me wondering about this issue. We all know which TV news stations have a Republican or Democratic slant.  Similarly, cardio

Back when I was a medical student, resident and then fellow I was taught that evidence-based medicine carried the solution to all medical conundrums. If we didn’t know which treatment is better, why not do a well-constructed clinical trial to figure it out?

Medical school was tough. Not so much because we were learning how to care for patients, but that we were learning the minutia of the human body. The sheer amount of detail that goes into understanding physiology, anatomy, and how all the organ systems interrelate in disease is, to say the least, intense and often intimidating. Yet, we all learn the science and through it all we learn that a thorough understanding of this science can make you a great Doctor. Why? Because you may find the answer that someone else missed, solely because your knowledge base was superior.

Back when I was a fellow, my mentors were physicians who masterfully waded through the seas of clinical care, research and education, always able to remain focused on all three visions simultaneously. Historically, such physicians set the benchmark for academic excellence and national leadership. Somewhat naively, I set about my career firmly intent on following in their esteemed footsteps, hoping to make my own contribution to the field.

But how does one do this? I quickly learned that planning an academic career is not as easy as one may think, and the biggest lesson of all was that yo

There’s no denying the impact of stroke. Not only is it the third leading cause of death, but it is in many ways more feared than heart disease or cancer. As interventionists, our sights have turned to three controversial procedures: (1) carotid stenting, (2) left atrial appendage isolation, and (3) PFO closure. While the first two concern older patients, the third affects those younger and often in the prime of life, throwing patient and physician fears and preferences into the debate. The argument for PFO closure goes something like this: (1) patients with cryptogenic stroke, especi