Mission Statement

• Endovascular technology has penetrated cardiology, radiology, and vascular surgery. The endovascular treatment of the thoracic and the abdominal aorta, the renal, the iliac and the carotid artery has become reality. Our vascular surgery colleagues were the first group of surgeons to adopt image-guided surgery and endoluminal technology, and have incorporated these in the practice. They have evolved into (endo)vascular specialist: Surgeons who can offer both open and endovascular (image-guided) options to the patients. Ultimately they improved the patient's quality of life (by offering less-invasive treatment options) and (in some cases) quality of care. The Thoracic surgeon must follow the path of our vascular surgery colleagues, and become competent with the endovascular procedures and the various imaging modalities, as endoluminal procedures on the great vessels and the heart may offer a superior outcome with less morbidity. The Thoracic surgeon should evolve into the cardiovascular specialist being capable of offering open and endovascular treatments to great vessels and the heart. The CTSnet Endovascular Portal has been established to help educate and improve the training of the cardiovascular specialist.
• Percutaneous approaches to the valvular heart disease are becoming reality in a selected patient population. Two percutaneous aortic valves have become commercially available in Europe, and are currently deployed our cardiovascular surgery and cardiology colleagues. The cardiovascular surgeon is most knowledgeable of valvular anatomy, is facile with large-bore access and femoral exposure, as well as left thoracic (apical) approach to the left ventricle necessary for the percutaneous valve devices. Last but not least, the cardiovascular surgeon is the only physician who can bail out a patient in extremis undergoing percutaneous valvular intervention with a conventional open valve replacement. On the other hand, he does not possess the interventional coronary skills of our cardiology colleagues necessary in some of these procedures. Therefore a close collaboration between the specialties is mandatory for reduce morbidity and mortality of these high-risk patients undergoing percutaneous valve therapies. The CTSnet Endovascular Portal has been established to help educate and improve the training of the cardiovascular surgeons in percutaneous valvular therapeutics.
• Thoracic surgeons have been reading chest/cardiac CT’s and MRI’s and coronary angiograms for many years. The operative treatment of the patient is based on our reading of the chest imaging. In fact, Thoracic surgeons are the only specialist who can correlate preoperative chest imaging with intraoperative findings. Given this long tradition, Thoracic surgeons are best suited to read the cardiac CT and cardiac MR, they should be active in getting credentialed to read these studies.
• The principle "Primum non nocere" and aiming for clinical excellence must remain our first guideline. Although adoption to new technology has been the forte of Thoracic surgeon, the pressure for rapid adoption should not lead to compromise in the quality and safety of patient care.
• The mission of this section is to:
  
  1. Familiarize and educate Thoracic surgeons, residents and fellows in Thoracic Surgery with the basics and recent advances in endovascular technology.
  2. Offer recommendations for clinical training in various aspects of endovascular technology by Thoracic or Vascular surgeons.
  3. Look into the credentialing process for various endovascular procedures, as well as cardiac CT and cardiac MR.
  4. Provide access to Thoracic surgeons trained in endovascular technology to act as mentors for training candidates. These mentors can help interested surgeons and residents in training with clinical training, recommendations for the workplace, etc.
  5. Provide a forum for discussion of common issues and practices in endovascular technology.

Publication Date: 8-Jan-2007
Last Modified: 21-Aug-2008