COLLEGE OF CARDIAC SURGERY
ACTIVITY REPORT 2004
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
Cardiac Surgery in Belgium
1998 2000
• Number of centers 32 31
• Number of participating Centers 32 28
• Number of Cardiac Surgeons BACTS 131 120
• Cardiac Surgeons/center 4,12 4,28
• Nr of interventions 14.931 15.856
• Interventions/center 466,9 511,48
• Interventions/surgeon 113,97 132,13
• Interventions adult/pediatric 14.135/689 15.017/839
• Isolated CABG (on ECC) 8.678 6.887
• Isolated valve 1.759 2.378
• CABG without ECC 214 1.502
• Transplant Surgery /Heart 110/88 96/84
• Redo Surgery 794
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
SWOT analysis - 1
• Strength
- 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
SWOT -analysis 2
• Opportunities
– 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
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
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
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
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?
