RESUMO
INTRODUCTION: The number of applications for cardiothoracic surgery has been steadily dropping over the past decades. We aim to assess whether a 1-day cardiothoracic surgical skills conference could increase interest into the speciality. METHODS: Participants included in the study had to be medical students or junior doctors. Out of 57 delegates that attended the conference, 52 were enrolled in the study, and completed the pre-conference and post-conference questionnaires. Three introductory lectures were delivered by consultants in cardiothoracic surgery or cardiology in the morning, followed by three practical surgical workshops. We assessed demographics, confidence in and knowledge of procedures, and the change in participants' interest in the speciality pre- and post-conference. This study was conducted at St George's University of London. RESULTS: The interest to pursue a career in cardiothoracic surgery increased by 23% post-conference (p = .035). Confidence and knowledge in all procedures taught improved significantly after the conference (p < .05), with the highest increase seen in anastomosis of vessels (p < .0001). Preclinical students made up 57.7% of participants, majority of whom had not seen more than three surgical procedures. CONCLUSION: Our conference has shown to increase interest in cardiothoracic surgery and improve exposure to surgical skills, especially to those in early years of medical school. The surgical workshops improved student confidence and knowledge in procedures used within the field and the use of animal tissue improved participant experience. Further research is needed at other medical schools to assess whether a change in surgical skills teaching should be made to medical school curriculums.
RESUMO
This is a report of a 31-year-old male refugee, who was admitted to Intensive Therapy Unit after being found in severe chest pain after escaping extreme torture from his home country. He was found to have four nails in his thorax. These were removed using a subxiphoid video-assisted thorascopic surgery (VATS) technique. This technique allowed excellent visualization of the right, left and anterior mediastinal part of the chest and therefore preventing damage or injury to surrounding structures. This was particularly useful in a complex case such as this. By avoiding an intercoastal incision and intercostal manipulation, our patient had limited pain post-procedure facilitating an earlier aggressive mobilization program with potential benefit in terms of improved lung expansion, reduction of atelectasis and lung infections. With the right training, the technical challenges of using the technique should be overcome and thus the benefits of subxiphoid VATS will be offered to a larger portion of thoracic surgical patients.
RESUMO
A 49-year-old diabetic male was admitted to a hospital in 2018 following a 3-week history of worsening dyspnoea and pedal oedema. Early review and investigations indicated acute heart failure. Transthoracic echocardiogram (TTE) revealed mitral regurgitation (MR), aneurysmal change of the ventricles, a ventricular septal defect (VSD) and systolic dysfunction. Coronary angiogram demonstrated a significant left anterior descending and right coronary artery disease. He was diagnosed with a late presenting myocardial infarction (MI) with secondary mechanical complications. Mechanical complications of MI frequently require surgical intervention. The patient underwent a repair of VSD, mitral valve repair, excision of aneurysmal segment and coronary artery bypass grafting. Post-operative recovery was complicated by a sternal wound infection managed in conjunction with the plastic surgeons. A post-operative TTE showed a repaired ventricular septum and no residual MR. Early recognition and appropriate medical optimisation are required to achieve good patient outcomes.
RESUMO
[This corrects the article DOI: 10.1093/jscr/rjz256.].
