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4/23/2007 -- Infrared Scientist GREG MATIS appears with Cardiac Surgery Appliance maker RAY BERTOLERO.   SEGMENT 3 of 5

GREG MATIS is the Senior Scientist for Santa Barbara Infrared Inc. for the last 5 yrs working on Advanced Electro-Optical, Laser and Infrared Test Sets, Radiometry, and Dynamic Infrared Scene Projection.  Santa Barbara Infrared is a world leading supplier of standard and custom equipment for FLIR testing, IR detector testing, IR simulation, and IR/Visible/Laser boresight testing. http://www.sbir.com

RAY BERTOLERO is the Vice President of ESTECH Cardiac Surgery Specialists of San Ramon, California.  Estech makes dozens of products used daily by surgeons around the world.  Take a listen as he tells us about their EXCITING new BREAKTHRU CURES for Stage 3 heart failure and Atrial Fibrilation!!! http://www.estech.com/


Wayne B. Norris: And we’re back on the second half hour of Business and Technology.  I’m your host, Wayne B. Norris.  Last half hour, we heard from Greg Matis, senior scientist for Santa Barbara Infrared.  With us now, we have Ray Bertolero.  He’s the vice president of Estech Cardiac Surgery Specialists.  If you just tuned in, remember that this show will be rebroadcast at 10:00 p.m. Monday and 2:00 p.m. Sunday, West Coast time, and if you have any questions for the guests, you can call 564-1290 locally and 866‑564‑1290 from anywhere in the U.S.A.

                        Before we get started with the second half of the show, I just want to mention my other favorite local science group, the Kavli Institute for Theoretical Physics at UCSB.  It may be the best show in town, if not in the world, and they have a full program of lecturers this week – I guess they got their surfing done last week when it was a light program – and there are ongoing programs on Accretion and Explosion, the Astrophysics of Degenerate Stars, Strongly Correlated Phases in Condensed Matter and Degenerate Atomic Systems, and High Energy and Gravity.  These are generally open to the public.  You can see their Web site with a full program at http://www.kitp.ucsb.edu or link to it from this show’s Web site.

                        So Ray, tell us about Estech Cardiac Surgery Specialists.

Ray Bertolero:    Well, Wayne, Estech Cardiac Surgery was a company that was formed about 11 years ago by my brother and I and a cardiac surgeon named Jerome Reedman, and we founded the company to provide new techniques to help surgeons treat different varieties of cardiac disease.  And over the last 11 years, we’ve built a suite of products which help surgeons deal with the four major cardiac disease groups, which are atrial fibrillation, coronary artery disease, heart valve disease, and heart failure.  So what we do is we basically make products that enable advanced techniques that help treatment outcomes be improved for patients undergoing these procedures.

Wayne B. Norris: Wow.  You know, that’s – tell me just out of curiosity.  You mentioned heart failure.  It sounds colloquial enough so that there must be some – does that characterize just a whole broad spectrum of failure to beat or is there something specific?

Ray Bertolero:    Well, what happens is over time the heart degenerates, and there are certain types of causes of the degeneration, one of which – one major one is being heart attack.  And what happens during a heart attack is that the heart actually – one of your coronary arteries actually closes, and that does not allow oxygen-rich blood to flow to that area of the heart, so what happens is that little area of the heart that is supplied by that blocked artery, then the tissue actually dies.

                        It becomes ischemic.  It lacks oxygen, and then after the heart attack, you know, we can go in and do a bypass or stent or some intervention, but that dead area actually forms a scar.  And what happens is the shape of the heart where that scar is that’s not viable muscle – the shape of your heart then changes, so then your heart doesn’t beat effectively.  In other words, each time the heart contracts, it doesn’t pump an appropriate amount of blood.  And so what we’ve actually done is devised a product called the Blue Egg, and what surgeons can actually do is, they can go in and do a surgical procedure, and they actually use this Blue Egg as a sizer to actually go and resize the patient’s heart to the appropriate shape and –

Wayne B. Norris: Wow.

Ray Bertolero:    Yeah and it’s really – it’s probably one of the most rewarding procedures that we do, because patients, when they get to Class 3 heart failure, which is a rating, they really – 80 percent of those patients have – will die within one year.  And that’s what the mortality rate is when you get to Stage 3.  And after the procedure with the Blue Egg, they actually get down almost to Class 1, which basically is barely symptomatic.  So you take people who literally can’t, you know, walk across the room, and now they can return to normal activity, so that’s really one of the most exciting things we do.

Wayne B. Norris: Well, you know, now there’s probably – I bring a prejudice to this in that – and probably a lot of listeners here are similar in profile in that I kinda know a fair amount about physics and engineering and I’m a little bit more of a baby on – in terms of knowledge of physiology and medicine, so you were talking about a coronary artery.  How many coronary arteries actually are there?

Ray Bertolero:    Well, actually, there’s two major branches that come off your aorta so you’ve got a left branch and a right branch and then off of those are – so you’ve got your left main and then they go down and they branch out into smaller arteries and, generally, I mean the ones that you really count when you look at a diagram is probably, you know, less than 12.

                        They go into these little branches where they start characterizing them as, you know, Obtuse Marginal No. 1, No. 2, No. 3, but the main ones are the right coronary artery, the left main at the diagonal, which comes diagonally off of the left main, and the LAD, which is the left anterior descending, and the left ventricle is really the pump that supports you, that actually provides all of your blood pressure, so that the arteries on the left side are a little bit more important.  If those happen to shut down then you’re really in trouble.

Wayne B. Norris: Okay, wow.  So there’s literally 12 important coronary – and these are obviously the arteries that provide your heart with the power that it needs.

Ray Bertolero:    Right.  What they do is they deliver oxygen-rich blood to your heart, and that actually keeps the muscle viable so –.

Wayne B. Norris: Wow.  Now – so is there one of them that’s notoriously bad for having coronary artery disease?

Ray Bertolero:    Well, you know, the one that really affects people where they get chest pain is the left main and the anterior descending.  As that starts to narrow, there’s less blood flow, and the chest pain that you get, it’s exactly like – you know how – remember when you were a kid and you used to run real hard; you’d get that side pain?

Wayne B. Norris: Oh, yeah.

Ray Bertolero:    That’s actually, you know, oxygen deficit that you’re feeling, so as your coronary arteries narrow, right, then all of a sudden you get less oxygenated blood to the heart and – or to the heart muscle and you get that pain and that’s “angina,” and that’s caused by narrowing of coronary arteries and then, like I say, when that actually shuts down, that’s a heart attack.

Wayne B. Norris: Wow.  That actually sounds ghastly.

Ray Bertolero:    It is ghastly.

Wayne B. Norris: I mean it happens a lot but – you know.

Ray Bertolero:    That’s why we have procedures that fix those blockages.

Wayne B. Norris: Yeah.  That must be just an absolutely exciting area to be in.  That’s just – I can’t tell you how cool that sounds.  You know, here’s a quick question.  The physician that you’re working with, this almost kinda sounds like, “Oh, here he’s been doing surgery and he has all these brilliant ideas, so he attracted a bunch of brilliant people around him, and now he’s gonna do all of these things that he wished had been around for a long time.”  Is that pretty fair?

Ray Bertolero:    Actually, it’s kinda the opposite way around.  You know, as a businessman, being in a cardiac industry for many years, you see what physicians need and what would advance it, and the thing about these surgeons that we deal with, a few of them are innovators, but the vast majority of them, you know, are very conservative, because literally the patient’s life is their hands.

Wayne B. Norris: Oh, sure.

Ray Bertolero:    And so they don’t want to really make changes.  They have a tendency to want to keep doing things the way they’ve been doing them.

Wayne B. Norris: Well, things that work.

Ray Bertolero:    Right.  And so what we’ve done is said, “How can we make this work better for them?”  And so, actually, you know, it’s a combination of us looking at what they’re doing and saying, “How can this be better?” and Estech was actually founded on the basis of being able to do everything through small incisions.  In other words, little two-inch incisions, rather than the big, you know, chest-cracking incisions that, you know, where they split the patient wide open.

Wayne B. Norris: Oh, yeah.  That would take so long to heal.

Ray Bertolero:    So naturally we have – excuse me?

Wayne B. Norris: That must take so long to heal.

Ray Bertolero:    If you have it done where they split your chest, it takes months, so two to three months.  We do these minimally invasive procedures now through small incisions between the ribs, and it’s literally taken it from days or weeks before you’re back to full activity instead of the months, that it is when your chest is split.

Wayne B. Norris: Wow.  We’re coming up on our break here.  We’ve got some messages.  We’ll be right back.  This is Wayne B. Norris, your host of Business and Technology and we’re talking to Ray Bertolero, vice president of Estech Cardiac Surgery Specialists.

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