1. COLLEGE OF CARDIAC SURGERY
ACTIVITY REPORT 2004

2. Members of the College Dr Inez Rodrigus Dr Guido Vannooten
Dr Philippe Kohl
Dr Christiaan Van Kerrebrouck
Dr Frank Van Praet
Dr Jean-Marie Desmet

3. Cardiac Surgery in Belgium
Number of centers
Number of participating Centers
Number of Cardiac Surgeons BACTS
Cardiac Surgeons/center , ,28
Nr of interventions
Interventions/center , ,48
Interventions/surgeon , ,13
Interventions adult/pediatric / /839
Isolated CABG (on ECC)
Isolated valve
CABG without ECC
Transplant Surgery /Heart / /84
Redo Surgery

4. Dynamic Analysis Referred exclusively by cardiologists Pre-op visit
Bedside visit at the moment of angiography
Ambulatory consultation
Referral by telephone/letter
Surgical Intervention
Pre-op investigation(ambulatory)
Surgery
Post op care (intensive care, medium care, ward)
Mean length of stay?
Post op follow-up
One or more ambulatory visits
Long term follow-up by cardiologists

5. SWOT analysis - 1 Strength Weaknesses Unique cost and risk per patient
Cardiac operations are reproducible and durable
Overall good 5 and 10 y survival without added morbidity
Lifesaving in acute conditions
Weaknesses
Dependence on cardiologist’s referral without multidicsiplinary consultations
Many centers, no definition of minimal required workload
Delayed reimbursement for New Technologies

6. SWOT -analysis 2 Opportunities Threats Homogeneous study populations
Opportunities for biomedical science
Core mission is accomplishment of excellent surgical care
Fundamental and applied research tradition must be supported
Threats
Further sparing and limitations of health care expenditures by the Government
Increasing competition from other specialists
Loss of social esteem and respect for the medical profession
Declining residency programs
Underpayment for high risk surgery
Referral patterns

7. Priorities
Updating nomenclature codes (redo surgery, assist device placement,etc…)
Better participation in governmental and RIZI/INAMI consultative bodies (technical committees)
Training programs
- redefining residency programs
- need for Physician Assistants

8. Activities of the College of Cardiac Surgery
The intent of a database is to trend outcomes over time and to establish benchmarks against which to measure and refine their work
Ability to monitor our clinical effectiveness and promote quality environment
Initial work of the QCC was crossed by the installation of the College for Cardiac Pathology
New database committee is at work again

9. SWOT-analysis of the College (1)
Strength
Homogenous subgroups in cardiac surgery
Data gathering should be easy
Weaknesses
Data gathering is in fact not easy
Confidentiality
Costs of data management (software,hardware,data manager)
Surgical database should include comorbidities, technical details

10. SWOT- analysis of the College (2)
Opportunities
Databases potentially benefit future patients and the public
Databases can determine the value of new techniques
Threats
What is the individual or institutional drive towards cooperation?

11. Conclusions
The activity of the former College of Cardiac Pathology has not contributed to a better patient care
There is a profound degree of skepticism amongst cardiac surgeons about the value of the College
The individual and institutional drive towards cooperation should be encouraged