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Eur J Cardiothorac Surg 2004;26:1063-1072
© 2004 Elsevier Science NL


EACTS Presidential address

The next challenge—adapting to change

James L. Monro*

Wessex Cardiothoracic Centre—Mailpoint 46, Southampton General Hospital, Tremona Road, Southampton SO16 6YD, UK

* Tel.: +44 2380 796241; fax: +44 2380 796614. (E-mail: monro1711@aol.com).

The first 300 words of the full text of this article appear below.

It has been a very great honour and climax to my career to serve as President of this Association and I would like to thank you for trusting me with this responsibility. It is always nice to be associated with success, and the birth and formative years of this Association have been an undoubted success, as can be seen from the increasing attendance at the Annual Meeting (Fig. 1).


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Fig. 1. The European Association for Cardiothoracic Surgery.

 
In his outstanding Honoured Guest Lecture in 1989 at the 3rd Annual Meeting of EACTS, John Kirklin showed three periods of cardiac surgical achievement [1]. First innovation, second consolidation and third scientific development. To those could perhaps be added for the next 15 years ‘competition’ (from our cardiology colleagues) and against this we could put ‘bureaucracy and litigation’ (Table 1).


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Table 1. Cardiac surgery (1954–2000)
 
The future

Foreseeing the future is an art. One can get quite a good idea from past trends, but we have to adapt and do the best we can, and this is our next challenge. Undoubtedly one of the major changes that has already occurred and will affect us more in the future is the reduction in coronary artery surgery. The increasing use of stenting by the cardiologists, and particularly with drug eluting stents, has resulted in fewer patients with coronary artery disease being treated primarily by surgery (Fig. 2). I say primarily because as coronary artery disease is a progressive disease, these patients will develop further stenoses and many will eventually come to surgery.


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Fig. 2. The annual incidence of percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) in the United Kingdom.

 
The result of this big increase in cardiological stenting is that the surgeons are left with the older, sicker patients with more . . . [Full Text of this Article]




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Copyright © 2004 European Association for Cardio-Thoracic Surgery. Published by Elsevier. All rights reserved.