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Future of cardiac surgery, introducing the interventional surgeon
Ebrahim Khaled Al-Ebrahim1, Turki Abdullah Madani1, Khaled Ebrahim Al-Ebrahim1
1Department of Surgery, King Abdulaziz University Hospital, King Abdulaziz University, Jeddah, Saudi Arabia.
Insights
Cardiac surgery is declining due to interventional cardiology advances. Recommendations include modifying resident training with catheterization laboratory experience to enhance cardiac surgery
Area of Science:
- Cardiology
- Cardiac Surgery
- Interventional Cardiology
Background:
- Advances in interventional cardiology have led to a decline in coronary and valvular surgery volumes.
- This trend has impacted cardiac surgery service and training programs, with a steady decrease in applications.
- The study addresses the need to identify weaknesses and propose improvements for the future of cardiac surgery.
Purpose of the Study:
- To identify the main weaknesses facing cardiac surgery.
- To advocate for recommendations to improve the current and future status of cardiac surgery.
- To address the declining trends in cardiac surgery applications and practice.
Main Methods:
- A cross-sectional study was conducted among cardiac surgeons and cardiologists in Saudi Arabia.
- Data was collected via email questionnaires sent to 200 participants.
- 55 responses were received and analyzed.
Main Results:
- 76% of respondents were cardiac surgeons, 24% cardiologists.
- Most respondents believe cardiac surgery volumes are lower than invasive cardiology.
- 91% consider cardiac surgery superior for complex lesions but riskier than invasive cardiology.
Conclusions:
- 83% of respondents advocate for modifying resident training.
- Training should include an additional year in Catheterization Laboratory procedures (coronary, valvular, aortic, arrhythmia).
- This aims to integrate interventional skills into surgical training, creating an 'interventional surgeon'.
Background:
The swift advances in interventional cardiology combined with the increasing risk of cardiac surgical procedures resulted in diminishing volume of coronary and valvular surgery and affected the future of cardiac surgery service and training. Application to cardiac surgery training programs have steadily declined. This cross-sectional study aimed at identifying main weakness facing cardiac surgery and advocating some recommendations to improve the status of current and future of cardiac surgery.
Methods:
Cross-sectional study was authorized by the institutional review board of King Abdulaziz University and performed among cardiac surgeons and cardiologists in the Kingdom of Saudi Arabia, from May to June 2021. Data were collected by sending questionnaires through email to cardiac surgeons and cardiologists in different cardiac centers all over Saudi Arabia. Out of 200 emails sent to our participants only 55 who responded.
Results:
A total of 55 doctors who participated in the study have completed the self-administered questionnaire by electronic mail. Seventy-six percent of the respondents are cardiac surgeons and 24% are cardiologists. Most of the respondents (72.7%, 63.6%) think that the volume of coronary and valvular cardiac surgery patients nowadays is less than before compared to invasive cardiology patients. Most of the respondents (91%) think that coronary cardiac surgery is better than invasive cardiology in left main disease and complex lesions but carries higher risk. Sixty-nine percent of the respondents think that one cardiac center in each city according to the population will provide better cardiac health services compared to small cardiac units.
Conclusion:
In the recommendations to improve the future of cardiac surgery, 83% of the respondents agree that residents training in cardiac surgery should be modified to add at least one extra year of training in the Catheterization Laboratory (Cath lab) procedures including coronary, valvular, aortic and arrhythmia, thus introducing the interventional surgeon.
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