Need of the hour: Structural heart intervention training for trainee surgeons in India
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YOUNG SURGEONS FORUM
Need of the hour: Structural heart intervention training for trainee surgeons in India Srikanth Kasturi 1 Received: 12 June 2020 / Revised: 30 July 2020 / Accepted: 4 August 2020 # Indian Association of Cardiovascular-Thoracic Surgeons 2020
Abstract Cardiothoracic surgery is on the verge of undergoing a major metamorphosis from being a conventional surgical branch to a technologically powered specialty with plenty of emphasis on learning the minimally invasive techniques, and a step forward is the advent of interventional techniques to treat most of the major cardiac ailments. Though the world of interventions has been traditionally dominated by the physicians, it is time we surgeons get ourselves actively involved in learning and performing these interventional procedures to stay relevant. This is not an attempt to disrupt the physician-surgeon harmony but to nurture a symbiotic relationship between the two specialties for advancement in cardiac science and technological growth, ultimately to benefit the patient. In this article, we discuss the Indian and the global scenario of the role of surgeons in the interventional arena and various training modalities available for surgeons to learn the art of cardiac interventions. We tried to understand the impediments in implementing interventional training for surgeons and also propose certain amendments to the way the future cardiothoracic surgeons are trained. Keywords Surgical training . Interventional cardiology . Wire skills . Heart team approach
Introduction The specialty of interventional cardiology, which was conceived in 1977 as a product of Dr. Andreas Gruntzig’s first successful coronary angioplasty, is experiencing a boom over the last couple of decades in terms of innovation and technological progress, courtesy the financial and industry support it enjoys. Encompassing the entire spectrum of adult and pediatric heart diseases, interventions have made inroads with excellent outcomes, better recovery, improved safety, and reduced overall costs to the patients receiving them. Though interventions are invasive procedures that should have been taken up by the surgeons right from the beginning, they were adopted and promoted by our physician counterparts. In the 1980s and 1990s, with the advent of better diagnostic modalities, newer cardiac diseases began to be unearthed and the surgical
* Srikanth Kasturi [email protected] 1
Department of Cardiothoracic Surgery, Narayana Institute of Cardiac Sciences, 258/A, Hosur Road, Bommasandra Industrial Area, Anekal Taluk, Bengaluru, Karnataka 560099, India
management of these pathologies kept the surgeons busy. Meanwhile, interventions were making steady progress advancing from coronaries to valves to congenital lesions. In the early 2000s, when the number of catheter-based interventions started shadowing and eventually overtook the number of surgical interventions, it caught the attention of the surgical community. But the physicians soon realized that they needed the backup of their sur
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