Does your program do VADS, heart and/or lung tx?

[ecCA1]

How many did you do of each and what were your experiences?

We do hearts and the occasional VAD, as well as a bundle of livers. It's a good experience, I guess, but unless you've done a bunch of each you don't really master the operation enough to do it as an attending at an academic institution without fellowship training.

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[UTSouthwestern]

Heart and lung transplants are not that technically difficult to master. Knowing what immunosuppressive protocols will be involved and having inotropic support ready are your main points of protocol that carry over from case to case.

VAD's are tricky but if you have good echo skills, you can usually diagnose technical difficulties fairly quickly.

Experience is the key and you shouldn't try to do these cases without a good amount of experience/training with these cases.

In residency, I did enough of each case to get to know the subtleties and I haven't had any difficulties in private practice with these cases when they pop up.

You have to decide at what point you feel ready to do these cases on your own.

 

[urge]

Heart and lung transplants are not that technically difficult to master.[/qoute]

Are you impliying that lung tx are easy?
You do transplants and VADs in private practice?

 

[jwk]

Heart and lung transplants are not that technically difficult to master.[/qoute]

Are you impliying that lung tx are easy?
You do transplants and VADs in private practice?

Another myth bites the dust

 

[Mman]

We do LVADs, heart, and lung transplants. I'd agree that a heart transplant isn't really that different from most other cardiac cases. Off pump double lung transplants, however, can be quite challenging with huge hemodynamic swings.

 

[UTSouthwestern]

Heart and lung transplants are not that technically difficult to master.[/qoute]

Are you impliying that lung tx are easy?
You do transplants and VADs in private practice?

Yes we do transplants and VADs in private practice. Baylor University Medical Center in downtown Dallas has a very busy transplant practice and VAD surgeon covering both Southwestern as well as private practice at BUMC. Medical City also has a busy heart transplant and VAD service which we help to cover at times.

Lung transplants in the hands of good surgeons are not that complicated. Lung transplants with fellows, residents, and medical students participating are very trying.

 

[VentdependenT]

By "trying" UT means "highly educational"

 

[Sevo]

How many did you do of each and what were your experiences?

We do hearts and the occasional VAD, as well as a bundle of livers. It's a good experience, I guess, but unless you've done a bunch of each you don't really master the operation enough to do it as an attending at an academic institution without fellowship training.

We (my fellow residents and I) were forced to do a ton of VADs, heart transplants, and single/double lungs during the last fourteen months of our training while the CRNAs did almost all the cases that I now do alone in private practice. I hated hearts so much that when I was done I never wanted to see another pump again, much less a TEE machine.

VADs, et al are done at private, non-academic facilities. My group covers the hearts at a large facility that does all of the above. That sort of call, fortunately enough, is limited to the CV trained guys. A typical day in the heart rooms at the other institutions that we cover usually consists of a few on pump CABGs and a VATS.