Victor Garcia

138 timestamped statements across 4 collections — auto-found in recorded discussions, each timestamp jumps to the exact moment.

Pectus Excavatum · guest expert

Featured diaries

▶ Ep 23 · 10:00
I come to this perspective from really an article by Jerome Grootman in the New Yorker, that then led me to a book, which I would argue everybody who's doing innovation in this space ought to read. And that is a expose as far as the abject failure, as far as how really the FDA and the government are monitoring the introduction of medical devices
quote · Pectus Excavatum
▶ Ep 3 · 10:00
I come to this perspective from really an article by Jerome Grootman in the New Yorker, that then led me to a book, which I would argue everybody who's doing innovation in this space ought to read. And that is a expose as far as the abject failure, as far as how really the FDA and the government are monitoring the introduction of medical devices
quote · Spontaneous Pneumothorax
▶ Ep 23 · 11:20
I remember when Ravage was introduced, and then we were doing it in you know, adolescence, and then we went into smaller children. And then we find ourselves in with acquired thoracic, you know, dystrophy, and asphyxia
quote · Pectus Excavatum
▶ Ep 3 · 11:20
I remember when Ravage was introduced, and then we were doing it in you know, adolescence, and then we went into smaller children. And then we find ourselves in with acquired thoracic, you know, dystrophy, and asphyxia
quote · Spontaneous Pneumothorax
▶ Ep 1 · 3:24
You know, unlike drugs, medical devices and implants are not, are not required to undergo clinical trials before they're introduced into the market.
quote · Shortness of Breath On Exertion
▶ Ep 1 · 3:01
I agree with Sean. It works. I mean, it is great, one day. Yeah, no. So, um, what I'm concerned about is, is that there are no long-term studies.
quote · Shortness of Breath On Exertion

Nothing matches these filters — clear the search or widen the filters.

Pectus Carinatum 8 entries

Pectus - Preoperative Assessment - Radiology and Cardiac Evaluation

▶ Ep 4 · 2:48
clinical The Cincinnati Children's approach is selective in identifying patients who will benefit from surgery and emphasizes helping patients and parents deal with pain and discomfort, minimizing workup risks (ionizing radiation), and mitigating chronic pain and substance abuse risk. ↗
▶ Ep 4 · 2:48
clinical Pectus excavatum repair is arguably the most painful operation that could be done in a child. ↗
▶ Ep 4 · 2:48
quote arguably what is the most painful operation that could be done in a child ↗
▶ Ep 4 · 31:08
guideline Insurance companies require some metric (abnormal pectus index plus evidence of cardiac dysfunction or abnormality) to approve coverage; providing multiple indices (Haller, correction, depression) plus cardiac dysfunction evidence has been effective in reversing denials. ↗
▶ Ep 4 · 42:03
host_summary Dr. Park in Korea, who performs the largest number of pectus repairs worldwide, argues that age 3 and older is safe for repair, and earlier is better. ↗
▶ Ep 4 · 42:31
clinical When operating on younger patients, bars need to be shorter (not extending to mid-axillary line) to avoid impeding chest wall growth. ↗
▶ Ep 4 · 43:01
host_summary Overcorrection from excavatum to carinatum can occur if repair is done too early, particularly in patients with connective tissue disorders (reported by Hopkins group). ↗
▶ Ep 4 · 43:35
host_summary Dr. Park reports seeing fewer asymmetric pectus patients because he corrects them when they're younger, suggesting early correction may prevent asymmetry development. ↗
Pectus Excavatum 95 entries

Pectus - Preoperative Assessment - Radiology and Cardiac Evaluation

▶ Ep 8 · 2:48
clinical Pectus excavatum repair is arguably the most painful operation that could be done in a child. ↗
▶ Ep 8 · 2:48
clinical The Cincinnati Children's approach is selective in identifying patients who will benefit from surgery and emphasizes helping patients and parents deal with pain and discomfort, minimizing workup risks (ionizing radiation), and mitigating chronic pain and substance abuse risk. ↗
▶ Ep 8 · 2:48
clinical The Cincinnati Children's approach is selective in identifying patients who will benefit from surgery and emphasizes helping patients and parents deal with pain and discomfort, minimizing workup risks (ionizing radiation), and mitigating chronic pain and substance abuse risk. ↗
▶ Ep 8 · 2:48
clinical Pectus excavatum repair is arguably the most painful operation that could be done in a child. ↗
▶ Ep 8 · 2:48
quote arguably what is the most painful operation that could be done in a child ↗
▶ Ep 8 · 2:48
quote arguably what is the most painful operation that could be done in a child ↗
▶ Ep 8 · 31:08
guideline Insurance companies require some metric (abnormal pectus index plus evidence of cardiac dysfunction or abnormality) to approve coverage; providing multiple indices (Haller, correction, depression) plus cardiac dysfunction evidence has been effective in reversing denials. ↗
▶ Ep 8 · 31:08
guideline Insurance companies require some metric (abnormal pectus index plus evidence of cardiac dysfunction or abnormality) to approve coverage; providing multiple indices (Haller, correction, depression) plus cardiac dysfunction evidence has been effective in reversing denials. ↗
▶ Ep 8 · 42:03
opinion Dr. Park in Korea, who performs the largest number of pectus repairs worldwide, argues that age 3 and older is safe for repair, and earlier is better. ↗
▶ Ep 8 · 42:03
host_summary Dr. Park in Korea, who performs the largest number of pectus repairs worldwide, argues that age 3 and older is safe for repair, and earlier is better. ↗
▶ Ep 8 · 42:31
clinical When operating on younger patients, bars need to be shorter (not extending to mid-axillary line) to avoid impeding chest wall growth. ↗
▶ Ep 8 · 42:31
clinical When operating on younger patients, bars need to be shorter (not extending to mid-axillary line) to avoid impeding chest wall growth. ↗
▶ Ep 8 · 43:01
host_summary Overcorrection from excavatum to carinatum can occur if repair is done too early, particularly in patients with connective tissue disorders (reported by Hopkins group). ↗
▶ Ep 8 · 43:01
clinical Overcorrection from excavatum to carinatum can occur if repair is done too early, particularly in patients with connective tissue disorders (reported by Hopkins group). ↗
▶ Ep 8 · 43:35
opinion Dr. Park reports seeing fewer asymmetric pectus patients because he corrects them when they're younger, suggesting early correction may prevent asymmetry development. ↗
▶ Ep 8 · 43:35
host_summary Dr. Park reports seeing fewer asymmetric pectus patients because he corrects them when they're younger, suggesting early correction may prevent asymmetry development. ↗

Update Course Rewind 2021 - Updates in Pectus

▶ Ep 23 · 10:00
quote I come to this perspective from really an article by Jerome Grootman in the New Yorker, that then led me to a book, which I would argue everybody who's doing innovation in this space ought to read. And that is a expose as far as the abject failure, as far as how really the FDA and the government are monitoring the introduction of medical devices ↗
▶ Ep 23 · 10:40
guideline Medical devices and implants are not required to undergo clinical trials before market introduction, unlike drugs. ↗
▶ Ep 23 · 11:20
quote I remember when Ravage was introduced, and then we were doing it in you know, adolescence, and then we went into smaller children. And then we find ourselves in with acquired thoracic, you know, dystrophy, and asphyxia ↗
▶ Ep 23 · 13:00
quote there are also cases in social media who are talking about the fact that they're on gabapentin. And when is this terrible nerve pain going to disappear? ↗
▶ Ep 23 · 14:10
guideline Cryotherapy devices received FDA approval via 510(k) predicate pathway based on similarity to devices from 1976, not based on clinical trials. ↗
▶ Ep 23 · 17:00
quote I challenge anybody on this panel to tell me that they're not long term consequences. And what are we going to do about that? ↗
▶ Ep 23 · 28:20
clinical With erector spinae catheters, hospital stay is two days with reduced opioid requirements both in-hospital and post-discharge. ↗

APSA - Is same day discharge possible following the Nuss repair for pectus excavatum - R. Luke Rettig

▶ Ep 24 · 4:37
quote I wanna begin with the question, uh, just because it can be done, uh, should it be done? ↗
▶ Ep 24 · 4:37
quote I wanna begin with the question, uh, just because it can be done, uh, should it be done? ↗
▶ Ep 24 · 4:42
quote I personally don't feel that cryoablation is ready for prime time. ↗
▶ Ep 24 · 4:42
quote I personally don't feel that cryoablation is ready for prime time. ↗
▶ Ep 24 · 4:48
quote We really don't know what the long-term consequences of this. ↗
▶ Ep 24 · 4:48
quote We really don't know what the long-term consequences of this. ↗
▶ Ep 24 · 4:53
opinion Medical devices typically are not subjected to the same rigorous, robust trials that drugs are ↗
▶ Ep 24 · 4:53
opinion Medical devices typically are not subjected to the same rigorous, robust trials that drugs are ↗
▶ Ep 24 · 5:24
opinion Many adverse consequences for medical devices are either underreported or not reported, as suggested by Kaiser Health News ↗
▶ Ep 24 · 5:24
opinion Many adverse consequences for medical devices are either underreported or not reported, as suggested by Kaiser Health News ↗
▶ Ep 24 · 5:41
opinion The long-term consequences of cryoablation are unknown, particularly for children ↗
▶ Ep 24 · 5:41
opinion The long-term consequences of cryoablation are unknown, particularly for children ↗
▶ Ep 24 · 5:52
opinion There is concern about chronic neuropathic pain as a potential consequence of cryoablation ↗
▶ Ep 24 · 5:52
opinion There is concern about chronic neuropathic pain as a potential consequence of cryoablation ↗
▶ Ep 24 · 6:24
quote I'm arguing for a trial, randomized controlled trial, as well as a registry so that we can track right Doctor Red results. ↗
▶ Ep 24 · 6:24
quote I'm arguing for a trial, randomized controlled trial, as well as a registry so that we can track right Doctor Red results. ↗

Update Course Rewind: Pectus Excavatum 2021

▶ Ep 25 · 3:01
opinion Dr. Garcia's concern about cryoanalgesia is the absence of long-term studies and unknown potential for future adverse effects such as chronic neuropathic pain. ↗
▶ Ep 25 · 3:01
opinion Dr. Garcia's concern about cryoanalgesia is the absence of long-term studies and unknown potential for future adverse effects such as chronic neuropathic pain. ↗
▶ Ep 25 · 3:01
quote I agree with Sean. It works. I mean, it is great, one day. Yeah, no. So, um, what I'm concerned about is, is that there are no long-term studies. ↗
▶ Ep 25 · 3:01
quote I agree with Sean. It works. I mean, it is great, one day. Yeah, no. So, um, what I'm concerned about is, is that there are no long-term studies. ↗
▶ Ep 25 · 3:09
quote But I believe we just don't know. We don't have the long-term data. ↗
▶ Ep 25 · 3:09
quote But I believe we just don't know. We don't have the long-term data. ↗
▶ Ep 25 · 3:24
quote You know, unlike drugs, medical devices and implants are not, are not required to undergo clinical trials before they're introduced into the market. ↗
▶ Ep 25 · 3:24
quote You know, unlike drugs, medical devices and implants are not, are not required to undergo clinical trials before they're introduced into the market. ↗
▶ Ep 25 · 3:24
guideline Unlike drugs, medical devices and implants are not required to undergo clinical trials before being introduced to the market by the FDA. ↗
▶ Ep 25 · 3:24
guideline Unlike drugs, medical devices and implants are not required to undergo clinical trials before being introduced to the market by the FDA. ↗
▶ Ep 25 · 3:55
clinical Dr. Garcia's institution studied approximately 100 patients comparing epidurals to erector spinal catheters for pectus excavatum pain management. ↗
▶ Ep 25 · 3:55
clinical Dr. Garcia's institution studied approximately 100 patients comparing epidurals to erector spinal catheters for pectus excavatum pain management. ↗
▶ Ep 25 · 4:08
clinical Erector spinal catheters are placed by the pain team with ultrasound guidance and are positioned juxtaposed to but not in the vertebral space. ↗
▶ Ep 25 · 4:08
clinical Erector spinal catheters are placed by the pain team with ultrasound guidance and are positioned juxtaposed to but not in the vertebral space. ↗
▶ Ep 25 · 4:19
quote Those catheters stay in for 5 days. The hospital stay is 2 days. 3rd day, while they're outside, the catheters are pulled out by the family. ↗
▶ Ep 25 · 4:19
clinical With erector spinal catheters, the catheters stay in for 5 days, hospital stay is 2 days, and on the 3rd day while patients are at home, the catheters are pulled out by the family. ↗
▶ Ep 25 · 4:19
clinical With erector spinal catheters, the catheters stay in for 5 days, hospital stay is 2 days, and on the 3rd day while patients are at home, the catheters are pulled out by the family. ↗
▶ Ep 25 · 4:19
quote Those catheters stay in for 5 days. The hospital stay is 2 days. 3rd day, while they're outside, the catheters are pulled out by the family. ↗
▶ Ep 25 · 4:31
clinical Dr. Garcia's institution achieved 2-day hospital stays with erector spinal catheters and reduced opioid requirements both in-hospital and at home. ↗
▶ Ep 25 · 4:31
clinical Dr. Garcia's institution achieved 2-day hospital stays with erector spinal catheters and reduced opioid requirements both in-hospital and at home. ↗
▶ Ep 25 · 4:45
clinical Erector spinal catheters achieve shorter stays than the 4-5 days seen with epidurals, though not the one-day stays achieved with cryoanalgesia. ↗
▶ Ep 25 · 4:45
clinical Erector spinal catheters achieve shorter stays than the 4-5 days seen with epidurals, though not the one-day stays achieved with cryoanalgesia. ↗
▶ Ep 25 · 8:08
host_summary Dr. Wolon uses a sternal elevator for pectus excavatum repair at Akron Children's Hospital. ↗
▶ Ep 25 · 8:08
clinical Dr. Wolon uses a sternal elevator for pectus excavatum repair at Akron Children's Hospital. ↗
▶ Ep 25 · 8:35
quote Steve, we use the um elevator in every case, uh, but it offers, uh, there's no guesswork. ↗
▶ Ep 25 · 8:35
clinical Dr. Garcia uses the sternal elevator in every case because it eliminates guesswork and allows entry and exit at the same interspace. ↗
▶ Ep 25 · 8:35
clinical Dr. Garcia uses the sternal elevator in every case because it eliminates guesswork and allows entry and exit at the same interspace. ↗
▶ Ep 25 · 8:35
quote Steve, we use the um elevator in every case, uh, but it offers, uh, there's no guesswork. ↗

Update Course Rewind: Pectus Excavatum 2021

▶ Ep 26 · 3:01
quote I agree with Sean. It works. I mean, it is great, one day. ↗
▶ Ep 26 · 3:01
quote I agree with Sean. It works. I mean, it is great, one day. ↗
▶ Ep 26 · 3:04
clinical There are no long-term studies on cryoanalgesia outcomes. ↗
▶ Ep 26 · 3:04
clinical There are no long-term studies on cryoanalgesia outcomes. ↗
▶ Ep 26 · 3:04
quote What I'm concerned about is, is that there are no long-term studies. ↗
▶ Ep 26 · 3:04
quote What I'm concerned about is, is that there are no long-term studies. ↗
▶ Ep 26 · 3:11
quote We don't have the long-term data. ↗
▶ Ep 26 · 3:11
quote We don't have the long-term data. ↗
▶ Ep 26 · 3:24
quote Unlike drugs, medical devices and implants are not, are not required to undergo clinical trials before they're introduced into the market. ↗
▶ Ep 26 · 3:24
guideline Medical devices and implants are not required to undergo clinical trials before being introduced to market, unlike drugs. ↗
▶ Ep 26 · 3:24
guideline Medical devices and implants are not required to undergo clinical trials before being introduced to market, unlike drugs. ↗
▶ Ep 26 · 3:24
quote Unlike drugs, medical devices and implants are not, are not required to undergo clinical trials before they're introduced into the market. ↗
▶ Ep 26 · 4:09
clinical Erector spinal catheters are placed by the pain team with ultrasound guidance, positioned juxtaposed to but not in the vertebral space. ↗
▶ Ep 26 · 4:09
clinical Erector spinal catheters are placed by the pain team with ultrasound guidance, positioned juxtaposed to but not in the vertebral space. ↗
▶ Ep 26 · 4:19
quote Those catheters stay in for 5 days. The hospital stay is 2 days. 3rd day, while they're outside, the catheters are pulled out by the family. ↗
▶ Ep 26 · 4:19
clinical With erector spinal catheters, hospital stay is 2 days, catheters stay in for 5 days, and are pulled out by the family on day 3 while the patient is at home. ↗
▶ Ep 26 · 4:19
quote Those catheters stay in for 5 days. The hospital stay is 2 days. 3rd day, while they're outside, the catheters are pulled out by the family. ↗
▶ Ep 26 · 4:19
clinical With erector spinal catheters, hospital stay is 2 days, catheters stay in for 5 days, and are pulled out by the family on day 3 while the patient is at home. ↗
▶ Ep 26 · 4:33
clinical Erector spinal catheters reduced opioid requirements both in the hospital and outside the hospital. ↗
▶ Ep 26 · 4:33
clinical Erector spinal catheters reduced opioid requirements both in the hospital and outside the hospital. ↗
▶ Ep 26 · 4:33
quote We've been able to reduce the opioid requirements, uh, not only in the hospital, but also outside of the hospital. ↗
▶ Ep 26 · 4:33
quote We've been able to reduce the opioid requirements, uh, not only in the hospital, but also outside of the hospital. ↗
▶ Ep 26 · 4:45
clinical With erector spinal catheters, hospital stays are 2 days, which is much less than the 4-5 days seen with epidurals. ↗
▶ Ep 26 · 4:45
clinical With erector spinal catheters, hospital stays are 2 days, which is much less than the 4-5 days seen with epidurals. ↗
▶ Ep 26 · 8:35
quote Steve, we use the um elevator in every case, uh, but it offers, uh, there's no guesswork. ↗
▶ Ep 26 · 8:35
clinical Using a sternal elevator in every case eliminates guesswork and allows entry and exit at the same interspace. ↗
▶ Ep 26 · 8:35
quote Steve, we use the um elevator in every case, uh, but it offers, uh, there's no guesswork. ↗
▶ Ep 26 · 8:35
clinical Using a sternal elevator in every case eliminates guesswork and allows entry and exit at the same interspace. ↗
Shortness of Breath On Exertion 28 entries

Update Course Rewind: Pectus Excavatum 2021

▶ Ep 1 · 3:01
opinion Dr. Garcia's concern about cryoanalgesia is the absence of long-term studies and unknown potential for future adverse effects such as chronic neuropathic pain. ↗
▶ Ep 1 · 3:01
quote I agree with Sean. It works. I mean, it is great, one day. Yeah, no. So, um, what I'm concerned about is, is that there are no long-term studies. ↗
▶ Ep 1 · 3:09
quote But I believe we just don't know. We don't have the long-term data. ↗
▶ Ep 1 · 3:24
quote You know, unlike drugs, medical devices and implants are not, are not required to undergo clinical trials before they're introduced into the market. ↗
▶ Ep 1 · 3:24
guideline Unlike drugs, medical devices and implants are not required to undergo clinical trials before being introduced to the market by the FDA. ↗
▶ Ep 1 · 3:55
clinical Dr. Garcia's institution studied approximately 100 patients comparing epidurals to erector spinal catheters for pectus excavatum pain management. ↗
▶ Ep 1 · 4:08
clinical Erector spinal catheters are placed by the pain team with ultrasound guidance and are positioned juxtaposed to but not in the vertebral space. ↗
▶ Ep 1 · 4:19
quote Those catheters stay in for 5 days. The hospital stay is 2 days. 3rd day, while they're outside, the catheters are pulled out by the family. ↗
▶ Ep 1 · 4:19
clinical With erector spinal catheters, the catheters stay in for 5 days, hospital stay is 2 days, and on the 3rd day while patients are at home, the catheters are pulled out by the family. ↗
▶ Ep 1 · 4:31
clinical Dr. Garcia's institution achieved 2-day hospital stays with erector spinal catheters and reduced opioid requirements both in-hospital and at home. ↗
▶ Ep 1 · 4:45
clinical Erector spinal catheters achieve shorter stays than the 4-5 days seen with epidurals, though not the one-day stays achieved with cryoanalgesia. ↗
▶ Ep 1 · 8:08
host_summary Dr. Wolon uses a sternal elevator for pectus excavatum repair at Akron Children's Hospital. ↗
▶ Ep 1 · 8:35
clinical Dr. Garcia uses the sternal elevator in every case because it eliminates guesswork and allows entry and exit at the same interspace. ↗
▶ Ep 1 · 8:35
quote Steve, we use the um elevator in every case, uh, but it offers, uh, there's no guesswork. ↗

Update Course Rewind: Pectus Excavatum 2021

▶ Ep 2 · 3:01
quote I agree with Sean. It works. I mean, it is great, one day. ↗
▶ Ep 2 · 3:04
clinical There are no long-term studies on cryoanalgesia outcomes. ↗
▶ Ep 2 · 3:04
quote What I'm concerned about is, is that there are no long-term studies. ↗
▶ Ep 2 · 3:11
quote We don't have the long-term data. ↗
▶ Ep 2 · 3:24
quote Unlike drugs, medical devices and implants are not, are not required to undergo clinical trials before they're introduced into the market. ↗
▶ Ep 2 · 3:24
guideline Medical devices and implants are not required to undergo clinical trials before being introduced to market, unlike drugs. ↗
▶ Ep 2 · 4:09
clinical Erector spinal catheters are placed by the pain team with ultrasound guidance, positioned juxtaposed to but not in the vertebral space. ↗
▶ Ep 2 · 4:19
clinical With erector spinal catheters, hospital stay is 2 days, catheters stay in for 5 days, and are pulled out by the family on day 3 while the patient is at home. ↗
▶ Ep 2 · 4:19
quote Those catheters stay in for 5 days. The hospital stay is 2 days. 3rd day, while they're outside, the catheters are pulled out by the family. ↗
▶ Ep 2 · 4:33
quote We've been able to reduce the opioid requirements, uh, not only in the hospital, but also outside of the hospital. ↗
▶ Ep 2 · 4:33
clinical Erector spinal catheters reduced opioid requirements both in the hospital and outside the hospital. ↗
▶ Ep 2 · 4:45
clinical With erector spinal catheters, hospital stays are 2 days, which is much less than the 4-5 days seen with epidurals. ↗
▶ Ep 2 · 8:35
clinical Using a sternal elevator in every case eliminates guesswork and allows entry and exit at the same interspace. ↗
▶ Ep 2 · 8:35
quote Steve, we use the um elevator in every case, uh, but it offers, uh, there's no guesswork. ↗
Spontaneous Pneumothorax 7 entries

Update Course Rewind 2021 - Updates in Pectus

▶ Ep 3 · 10:00
quote I come to this perspective from really an article by Jerome Grootman in the New Yorker, that then led me to a book, which I would argue everybody who's doing innovation in this space ought to read. And that is a expose as far as the abject failure, as far as how really the FDA and the government are monitoring the introduction of medical devices ↗
▶ Ep 3 · 10:40
guideline Medical devices and implants are not required to undergo clinical trials before market introduction, unlike drugs. ↗
▶ Ep 3 · 11:20
quote I remember when Ravage was introduced, and then we were doing it in you know, adolescence, and then we went into smaller children. And then we find ourselves in with acquired thoracic, you know, dystrophy, and asphyxia ↗
▶ Ep 3 · 13:00
quote there are also cases in social media who are talking about the fact that they're on gabapentin. And when is this terrible nerve pain going to disappear? ↗
▶ Ep 3 · 14:10
guideline Cryotherapy devices received FDA approval via 510(k) predicate pathway based on similarity to devices from 1976, not based on clinical trials. ↗
▶ Ep 3 · 17:00
quote I challenge anybody on this panel to tell me that they're not long term consequences. And what are we going to do about that? ↗
▶ Ep 3 · 28:20
clinical With erector spinae catheters, hospital stay is two days with reduced opioid requirements both in-hospital and post-discharge. ↗