MD Cardiac Surgery Endovascular

[mimi223344]

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Hey Everyone,
I understand that there are opportunities for integrated cardiac surgical residents to obtain endovascular skills with TAVR, TEVAR, and possibly TMVR when that comes out. I also understand that cardiology holds the referral basis and it is a lot more likely for them to refer within their own group i.e. a general cardiologist referring to an interventional cardiolgist vs. a cardiac surgeon. Do you think a "hybrid" cardiac surgeon could gain more referrals by selling themselves as their own backup should an open approach be necessary? That way you do not have to have an extra surgeon on standby? In addition, if there were a complication, would it not be better for the individual who created the complication (interventionalist) to be able to fix it versus another individual? I would imagine that there would be a delay in treatment as the surgeon has to be briefed on the situation, called in, and then the surgery occurs. With this in mind, I'm not sure if it really matters but in an integrated system like Kaiser, maybe this gives more of a selling point to hospital administrators. Let me know your thoughts either way.

Thank You

 

[mimi223344]

Hey Everyone,
I understand that there are opportunities for integrated cardiac surgical residents to obtain endovascular skills with TAVR, TEVAR, and possibly TMVR when that comes out. I also understand that cardiology holds the referral basis and it is a lot more likely for them to refer within their own group i.e. a general cardiologist referring to an interventional cardiolgist vs. a cardiac surgeon. Do you think a "hybrid" cardiac surgeon could gain more referrals by selling themselves as their own backup should an open approach be necessary? That way you do not have to have an extra surgeon on standby? In addition, if there were a complication, would it not be better for the individual who created the complication (interventionalist) to be able to fix it versus another individual? I would imagine that there would be a delay in treatment as the surgeon has to be briefed on the situation, called in, and then the surgery occurs. With this in mind, I'm not sure if it really matters but in an integrated system like Kaiser, maybe this gives more of a selling point to hospital administrators. Let me know your thoughts either way.

Thank You

By the way I am a medical student so if I am not posting this in the right place please let me know.

 

[mimi223344]

By the way I am a medical student so if I am not posting this in the right place please let me know.

I was also thinking that a cardiac surgeon could approach the situation from many different way such as transfemoral, transcaval, transapical, etc.

 

[libertyyne]

At my institution the interventional cards folks did most of the cardiac caths and stayed busy with that and the Cardiothoracic surgeons were in charge of selecting which modality to use in terms of open valve replacement vs TAVR. My very small understanding is that the endovascular procedures are only appropriate for a subset of patients, whereas the open procedure is the standard of care.

 

[libertyyne]

If you are ready to match, I would consult with your mentor regarding business side of things. These things often change and are different from institution to institution. There will always be need for CT surgeons for multi-vessel disease bypass.