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1King Fahad Cardiac Center, College of Medicine, King Saud University, P.O. Box 7805, Riyadh, 11472, Saudi Arábia. alsadd@hotmail.com
Insights
Cardiac surgery referrals are declining due to advances in interventional cardiology. Cardiac surgeons need new skills, like catheter-based interventions, to adapt to the evolving landscape of heart treatments.
Area of Science:
- Cardiology
- Cardiac Surgery
- Interventional Cardiology
Background:
- A significant global decline in coronary artery revascularization procedures is observed.
- This trend raises concerns for cardiac surgeons regarding practice, training, and the specialty's future.
Purpose of the Study:
- To analyze the changing patterns of cardiac catheterization management over two decades.
- To assess the impact of invasive cardiology advancements on cardiac surgery referrals.
Main Methods:
- Retrospective analysis of cardiac catheterization laboratory data from 1986 to 2006.
- Examination of patient management trends following cardiac catheterization.
Main Results:
- Referrals for coronary artery bypass grafting surgery have decreased significantly.
- The majority of patients now receive percutaneous coronary interventions (PCI) like angioplasty and stenting.
- A shift from surgical management to catheter-based interventions is evident.
Conclusions:
- Findings align with the consensus on the evolving nature of cardiac care.
- Cardiac surgeons may need to acquire new skills, including catheter-based interventions.
- Integrating interventional cardiology training is crucial for future cardiac surgeons.
Background:
There is a noticeable decline in the number of patients who undergo coronary artery revascularization procedures. The change is definite as it is reported by many centers around the world. This trend is of great concern to cardiac surgeons because of its impact on their practice, its adverse effect on training and the degree of uncertainty it throws into future of the specialty.
Methods:
The data of the cardiac catheterization laboratory at the King Fahad Cardiac Center in the period between 1986 and 2006 was examined looking at the changing pattern of management of patients who undergo cardiac catheterization.
Results:
In the early years, angioplasty was attempted in around 10% of patients leaving the rest for surgical consideration or medical therapy. Currently only 15% of patients who undergo selective coronary angiography are referred for surgery. The majority are offered angioplasty and stenting. The trend is towards more catheter-based interventions and less towards surgery.
Conclusions:
Our findings are in agreement with the general consensus about the specialty. Cardiac surgeons should perhaps consider acquiring new skills which may be outside the operating room. Adding catheter based intervention particularly in valves to cardiac surgery training would be a bonus for the future surgeons that will give them the necessary edge to meet the new challenges. It is incumbent on the leaders in the field to establish a clear strategy for the future.
Mini-Abstract:
Impact of advances in invasive cardiology on cardiac surgery, based on actual analysis of the pattern of referrals to surgery of over two decades.
