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Eur J Cardiothorac Surg 2004;26:S76-S77
© 2004 Elsevier Science NL

Working group report

Cardiology/cardiac surgery/vascular surgery—evolution to one speciality?

University College London, The Heart Hospital, 16-18 Westmoreland Street, London W1G 8PH, UK

^* Tel.: +44 20 7573 8888; fax: +44 207 573 8888. (Email: bruce.keogh{at}uhb.nhs.uk).

Abstract

Cardiac surgeons have varied practices generally covering revascularisation, and valve surgery with other subspeciality interests. Coronary surgery represents about 75% of cardiac surgical practice. Percutaneous interventions are reducing the referral rate for coronary surgery. The cardiologist who refers patients for surgery has a potential conflict of interest because he offers a treatment himself. Furthermore, cardiologists cannot deal with the major complications of the treatment they offer. This raised the issue of how best to integrate cardiological and surgical treatments. The options considered were: 1. The development of integrated clinics or multidisciplinary meetings for review of data on all patients prior to a decision on intervention. 2. Training of a new breed of surgical interventionist capable of performing all required interventions for a specific condition, e.g. coronary surgery and percutaneous coronary interventions. The development of integrated review of all patients prior to a decision on treatment was deemed problematic given that in the interests of the patient PCI should be performed, where possible, at the same time as the diagnostic angiography. The group dismissed the option of a single interventionist capable of performing both surgical and percutaneous interventions, with the single exception of aortic surgery and stenting procedures. The development of integrated review of all patients prior to a decision on treatment was deemed problematic given that in the interests of the patient PCI should be performed, where possible, at the same time as the diagnostic angiography. The group felt that EACTS should actively engage and collaborate with other organisations, such as the European Society of Cardiology, which were engaged in developing cardiovascular science or therapies, including industry.

Key Words: Cardiology • Cardiac surgery • Vascular surgery