The path we have traveled and what awaits us: a look at the prospects for the development of heart and aortic surgery

Abstract

In 2013, the Journal of Cardiothoracic and Vascular Anesthesia published an article dedicated to the 60th anniversary of the first successful open heart surgery using an artificial circulatory system (AIC). It was a turning point in the history of surgery. Over the past 70+ years, cardiac surgery has achieved a level and results. The real technological breakthrough in heart surgery was the transcatheter implantation of an aortic prosthesis (TAVI). This minimally invasive intervention opened the way for an alternative treatment for severe aortic valve stenosis. Recently, transcatheter implantation of mitral and tricuspid prostheses has been actively developed and clinically successfully applied. Minimally invasive transcatheter surgery will eventually occupy an absolutely dominant position. In this regard, a reasonable question arises: which of the specialists will perform the most difficult repeated operations, especially in the case of infection of aortic and vascular stents, prostheses and catheter valves? The solution to all tasks and problems is the creation of interdisciplinary centers where angiologists and vascular surgeons, cardiologists and cardiac surgeons will work "under one roof ", and where all stages of diagnosis, treatment and follow-up are links in the same chain. Such an organization of specialized surgical care and a locally high concentration of patients will make it possible to qualitatively improve the training of the younger generation of surgeons, taking into account the requirements of technological progress, and timely identify and effectively treat both early and late postoperative complications.