Heart Matters

Cardiac surgery and sports

by Stefanos Demertzis on 9 December 2018

The topic might seem a contradiction, how can it be possible to engage in intense sport with an operated heart? It is possible, but not for everyone and not in each case. The topic is complex and requires a differentiated approach. The major components of the equation are the following:

Nature of the disease
Functional condition of the heart
Response of the heart and of the whole cardiovascular system to the operation
Presence of any residual or other disease with particular relevance to intense sport
Attitude of the patient and his/her family
Sports history of the patient

Minimally invasive valve surgery: cannulation of the right axillary artery.

by Stefanos Demertzis on 16 October 2018

Our surgical technique for cannulation of the right axillary artery and fully percutaneous TEE-guided cannulation of the right atrium in minimally invasive valve surgery is presented with a video in the CTSNet. Our data point towards a better cerebral protection with this technique.

Taking teaching of (cardiac) surgery to another level

by Stefanos Demertzis on 7 August 2018

I very well remember my first experiences as a medical student in the operating room. I was ordered to stand in a corner with my back to the wall (just as the surgeon ordered), almost motionless because of the staff’s worry that I might touch and contaminate something sterile. I could only listen to the surgeon describing what he was doing. That was a humiliating experience and I was close to abandoning my goal of becoming a surgeon.

States of mind: #2 – Quality of care

by Stefanos Demertzis on 10 March 2018

Quality of medical and surgical care is a profoundly felt need of every patient, of every involved family. Although based on slightly different motivations, the same is requested by those who pay for the care. Therefore, the interest in defining and measuring the quality of provided care is high. This is, however, a highly complex endeavor. It requires in-depth knowledge, differentiation, multiple perspectives and expert judgment.

How can we define “quality of care”?

The Institute of Medicine (IOM) of the US National Academy of Sciences defines it as “the degree to which health services for individuals and population increase the likelihood of desired health outcomes and are consistent with current professional knowledge.”

Time for a new training model in cardiac surgery

by Stefanos Demertzis on 14 January 2018

Traditionally, technical skills in surgery are taught by the “apprentice model”: trainee surgeons learn under supervision in the operating room, by performing portions of or complete real operations on real patients.

A bolt out of the blue: acute aortic dissection

by Stefanos Demertzis on 4 September 2017

This is one of the biggest emergencies in heart surgery, or, dare I say, of medicine in general. From a subjective wellbeing, a sudden sharp and excruciating pain in the chest makes the person reach out for medical help. As soon as the patient arrives to the ER, a diagnostic protocol for acute chest pain is carried out. Once acute myocardial infarction is ruled out, the patient must undergo a CT scan to either exclude or confirm acute aortic dissection.

A year of radio silence

by Stefanos Demertzis on 28 August 2017

On June 10^th 2017, the formal graduation ceremony held at the TMEC Walter amphitheater at Harvard Medical School and the Certficate of Completion marked the end of a highly demanding yet interesting one-year training named GCSRT (Global Clinical Scholar Research Training). The study of key subjects in clinical research (biostatistics, epidemiology, ethics) was much deeper and thorough than expected. Side subjects such as self- and team management, as well as mentorship and leadership, were also integral part of the course.

Families

by Stefanos Demertzis on 4 April 2016

This post is a tribute to the families of our patients. To all families of all patients we care for. My thoughts especially go to the families whose relatives had a bad outcome, experienced a severe complication or who sadly did not survive surgery.

States of mind: #1 – less invasiveness (limited access cardiac surgery)

by Stefanos Demertzis on 19 April 2015

Cardiac surgery underwent a huge change since its beginnings. From an adventurous, dangerous but lifesaving endeavour carried out by real Mavericks to a surgery, which is perceived almost as routine and expected to be safe, with good and predictable results. While this latter is true (in the vast majority of cases), the change doesn’t end here: meanwhile, cardiac surgery is perceived as almost too invasive, mainly due to its standard surgical access, the median sternotomy (i.e. the longitudinal split of the long breast bone). The major invasiveness of the access to the heart is against the contemporary trend of minimal access to the internal organs, if possible through a catheter inserted in a peripheral vessel.

The new role

by Stefanos Demertzis on 31 January 2015

The foundation board of the Cardiocentro Ticino recently appointed me as the new head of the cardiac surgery department. The first day in my new position is 1^st February 2015.

In this new role all individual professional qualities, such as technical skills, clinical judgment and decision-making, are considered as granted. The new challenge is leadership.