Martin J. London, M.D., Professor in Residence, UCSF Anesthesia |
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Cardiac Surgery |
Society of Thoracic Surgeons/CTSNetThe Society of Thoracic Surgeons (STS) despite being called Thoracic, is the one of the biggest and most influential Cardiac Surgical societies in the world. The STS has a joint arrangement with a medical internet group (originally from Johns Hopkins University).This is called "CTSNet". This umbrella organization provides internet space and tools for a number of smaller surgical societies. CTSNet is very resident education oriented. A neat feature of the STS site is that it presents data from the STS Cardiac Surgical database which is a massive voluntary data reporting system which has generated lots of important clinical publications. The data has been used in multivariate analyses to generate risk scoring systems. STS/CTSNet hosts the Annals of Thoracic Surgery which is a clinically oriented cardiothoracic journal. The journal has published many good review articles (most of which are nice and short). Access to the full text of the journal is restricted to members, although anyone can search and get abstracts. They do post free full-text access to 2 featured articles per issue which also have open discussion forums (including one that I co-hosted). There usually isn't all that much in these forums, but occasionally they are interesting. This site excels at resident/fellow education efforts with lots of video presentations, a photo based "mystery case" section, and multimedia "grand rounds". Highlights of the annual meeting of the Society are also on-line. There is now free access to an electronic version of a textbook of adult cardiac surgery. The interface is slow and clunky (you really need a good PC or a Powermac) but the chapters (including cardiac anesthesia and monitoring) are quite good (and are good O.R. reading if you print them out). Annals of Thoracic Surgery Home Page Annals: Free Featured Articles CTSNet Photo Gallery (with Mystery Cases) STS National Cardiac Surgery Database On-Line Textbook of Adult Cardiac Surgery Minimally Invasive Cardiac SurgeryThis is an exciting area that you will be exposed to in your cardiac rotation. The surgeons at the VAMC are quite active in this area and that makes life exciting since standard on-pump CABG's are becoming a bit of a rarity around here! It's really helpful to know the surgical techniques and realize that this is a very "fluid" and dynamic field. Although less commonly performed around here, minimally invasive valve surgery is also a hot topic. The first case I was involved in at the University of Colorado, generated a neat TEE case report! CTSNet has much helpful information in this area. I've highlighted a few of the video and grand rounds links that I think will be helpful for you to review. You might also consider a trip to one or two of the medical manufacturers who sell the stabilizer systems used to allow the surgeon to sew on the beating heart. MIDCAB Complete Revascularization on the Beating Heart (real player streaming video) Limited incisions for CABG and Valve procedures (photo and video) Minimally Invasive Valve Surgery Case Presentation Medical Manufacturers Web Sites Medtronics Stabilizer System for MIDCAB (includes video)
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londonm@anesthesia.ucsf.edu
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