Cardiac surgery and sports
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.
States of mind: #1 – less invasiveness (limited access cardiac surgery)
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
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 1st 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.
Robotic cardiac surgery. A marketing fuss or a real benefit?
Robotic surgery has been hitting the headlines for years. Notwithstanding, it is not widely understood what robotic surgery is really about and what are the benefits and pitfalls of this technology.
Nowadays, when we talk about robotic surgery we mean surgery performed with the da Vinci telemanipulator (Intuitive Surgical, Sunnyvale, CA, USA). It is not the sole robotic system available, but it is indeed the most advanced authority cleared surgical robot. It is successfully commercialized worldwide and dominates almost 100% of the market.
The evolution of coronary artery bypass grafting: coronary surgery through small incisions (MICS-CABG).
The way to carry out an aortocoronary bypass has remained relatively unchanged during the last decades. The introduction of the beating heart surgery technique 10-15 years ago originated several technical and technological innovations, which made the procedure easier and safer. These developments created the potential for further approaches.
The latest evolution is performing the operation through a small incision under the left breast (mini-thoracotomy), also called MICS-CABG (minimally invasive cardiac surgery – coronary artery bypass grafting).