Mon 10 April 2017
I was delighted to attend the annual SCTS meeting in Manchester where I was truly honoured to moderate a session entitled “Minimally Invasive Mitral Valve – Master Series”. My co-moderators were eminent international colleagues in the field of cardiac surgery, namely, Dr. Patrick Perier, from Bad Neustadt/DE, and Mr. M Moorjani, from Papworth Hospital/UK.
The carefully prepared presentations were wonderfully delivered, and there was little doubt regarding the benefits of minimal access mitral surgery over traditional breast bone incision.
Preceding this session, there was an even more interesting debate between the protagonists and antagonists of keyhole mitral valve surgery. A show of hands at the end of the session represented a unanimous demonstration of support for minimal access mitral valve surgery amongst the learned surgeons in attendance.
Interestingly, there is one thing that both protagonists and antagonists of minimal access procedures agreed: Training was the key to reproducing the excellent outcomes seen in centres where surgeons have performed large volumes of minimal access mitral surgery.
Few would argue that Leipzig (under the superb leadership of Friedrich Mohr) has trained a large number of minimal access mitral surgeons over the last decade. Even in this exemplary training centre, however, there were occasions when surgeons were not able to reproduce the great results of their teachers.
Thus, it seems clear that surgeon specific attributes, structured training, and exposure to large enough volumes of cases are essential requirements to delivering a successful minimal access mitral valve repair program. No longer will it be acceptable for surgeons to visit an experienced centre once or twice and then perform a hand full of mentored cases before embarking upon a solo practice. A much more protracted training period that performance manages the surgeon through a structured period of learning, much in the way the Leipzig team have done, will now be the only way that UK surgeons can keep pace with the widening gap in super-specialised expertise that is beginning to emerge between them and other parts of the world.
The Keyhole Heart Clinic is committed to training surgeons for the future. We will be offering a comprehensive training program for surgeons and their teams and will be providing an update in the near future.
Meanwhile, I would like to thank the organisers of the annual SCTS meeting for creating such an academically stimulating program.