pdating postgraduate training in vascular/cardiothoracic surgery/ and clinical skills in cardiovascular medicine.
• Involved in preventive, diagnostic, and therapeutic services to patients in the vascular unit, on a clinic basis, (ABPI measurements, venous,arterial ulcer management, PAD management.)
• inpatient cardiology service,
• cardiovascular clinic,
• cardiac catherization and interventional laboratories,
• echocardiography laboratory, electrophysiology laboratory,
• Cath lab management
first assist
crash team/ALS
postoperative care including postoperative ICU:
• endotracheal intubation and mechanical ventilation, perenteral feeding, nasogastric tubes
• Trauma team, lead on occasion
• DNAR training of juniors and advising relatives
• insertion of central venous line,
• insertion of chest (intercostal) tube.(pneumo,/hemothoraces)diaphragmatic herniations
• Certifying brainstem death
• Death Certification,and relative notification.
• Organ Harvesting for transplant, (subject to relative consent)notification of PALS
• Weaning off ventilation machines/extubation and maintenance of airway and organstability
: • * saphenous vein harvesting,
• sternotomies. thoracotomies, minimally invasive inscisions
• VATS, Nuss
• Aortic dissection stenting, aortography, aneurysm repair,aortoplasty patch repairs
• transapical aortic valve replacements, observed as per cathlab briefly
• venous cannulation,Bypass cases,
* haemostasis cases * closure of sternotomy * ASD cases, VSD cases, On pump, Cardioplegia-cold and tympanic (crystalloid/blood)Off pump-subject to additional electrophysiological detection of arrhythmias,End to end anastomosis, end to side anastomsis, grafting, pedicle and scletonising vesels,First Assist
Mitral & aortic valve replacement
CABG operations
,correction of cong.(H.D) ASD, VSD, AV canal, Fallot’s tetralogy.PDA.
Bental,Ross, reopening Ross, Paediatric procedures,Norwood HLHS hybrid, etc
• Marfans
• ( Modified Dorr procedure)
• Ablations, fibre optic cryo, cox maze,(mini maze, 5 point)
• transplants, revisions, aortic arch grafting, aneurysms dissections. anastomosis, (side to end) Vascular flow second grade fluid dynamics, bifurcation back flow, plaque comp, placement, shear, stress, velocity, hence decision making on graft material
• hemostatic control, cardioplegia closing up, returning to Beating heart status
• team work with perfusionist and anaesthetist, patient is ready to return to beating heart status,Heart Lung machine knowledge, ECMO, PEEP, CPAP etc subject to lung deflation
• metabolic cooling, cold dialysis, cold lavage
• V.A.T.S, ensuring port placement is secure (Leeds Course)
• AF ablation as per above *Cox Maze,pacemaker insertion, single and dual chamber, dysnchronsy adaption
• * Internal mammary artery harvesting.LIMA, RIMA (pedicled and sceletonised)
• Transradial percutaneous Transcatheter minimally invasive techniques and training/Cathlab, Exit exam/European Board(CTSNET, SCTS,STS EACTS, ASGBI, ASIT)
ALS(Advanced life support)
ATLS(Advanced Trauma life support)
CCrISP(Care of the Critically Ill Surgical Patient)
MIC
Ettore Marjorane,International school of Cardiac surgery
Erice-Sicily
trauma
BSc MBBS MSc MRCS