Transfer of surgical knowledge: a continuous challenge

Cardiac surgery is an expensive method of treatment, and the population’s need will probably never be completely met, even in developed nations, as reflected by recent discussions about limits of care in aged and polymorbid patients. The problem is, of course, much more acute in less developed and developing nations, and their population needs are near impossible to cover. Major surgical associations have only limited funds available, and the transfer of knowledge remains the most efficient way of improving the level of surgical education in these countries, therefore improving care of cardiosurgical patients

Future of heart valve surgery

In highly developed nations, valve surgery will be increasing applied in older people, with more co-morbidities and a higher incidence of concomitant coronary artery disease. Valve surgeons will be facing increased competition from the catheter-based procedures, both for valve repair and replacement; these are already applied clinically, and their numbers will rise in near future. Early mortality in double valve procedures and in combined CABG and valve operations remains substantial, and there is ample room for improvement of surgical results. New valve prostheses are slow in development, due to financial restraints and exceeding cost of certification. Tissue-engineered valves are being developed, but are not ready for larger clinical trials. Cardiac surgery is undergoing a rapid transformation; radical changes both in scope and workload of cardiosurgical units in Europe can be expected in near future. Socio-economic factors and recent advances in medical technology contribute to these change