paediatric cardiovascular surgery

[Guest chilling]

Hey,

I was wondering whether anyone had any insight into paediatric cardiovascular surgery (mouthful!)...Compared to adult cardiac surgery (which I heard was VERY monotone and rather boring in terms of the number of procedures one does), how is the paediatric side? Are there a greater variety of procedures and stuff?

 

Also, does anyone have any experience or insight into the specialty itself? Like schedule, intensity, etc?

 

Finally, it has been mentioned that cardiac surgery is going down in the future (thanks to the interventionalists!)...is this the case with paediatric as well?

 

Thanks for any input!

[Guest aneliz]

Paediatric cardiac surgery is extremely specialised... and in Ontario, has been limited to only two centres by the government. Peads cardiac surgery is only available in Toronto and Ottawa. Patients from elsewhere have to travel to one of those two locations. This was apparently because the volume is too low to support more surgery programs in other cities.

 

As for variety, well... paeds cardiac surgery deals with congenital heart disease mostly... and there are a limited number of variations which are able to be repaired. While not quite the two trick pony of adult CV surgery (CABG and valve), it can only be so diverse when you are limiting yourself to a single organ...

[Guest 007]

I know one of the peds CV surgeons in Halifax covers both surgery at the children's hospital and works at the adult centre too (maybe just adult congenital corrections??). She is super busy and from what I can tell it is a very high stress job. There are two Peds cardiac surgeons in Halifax, which serves all of the Maritimes. The surgical schedule is fairly busy from what I can tell.

[studentz]

I don't think Ottawa does any paed's heart surgery any more.

 

There are about 120 procedures in paeds cardiac surgery, way more than in adult, and they are usually far more complex owing to the anatomy encountered in the congenital cases. Transplantation is only done at Toronto, Montreal and Edmonton with Toronto having by far the largest volumes. Having said that, it's still only ~20 transplants a year and I think the total case load is still less than adult. Also, because of the complexity, it's not as threatened by interventional cardiology as adult since you simply can't fix most of the problems through a catheter, especially the high risk ones. Lifestyle's probably an issue though since for many conditions ungent intervention is necessary and if a heart becomes available, well, you have to use it!

 

Where you can practice in this country is a significat issue, as is the fact that the most recent surgeons at Sick Kids are US-trained (Loma Linda and Columbia). And it takes bloody long to complete your training.

[UBCGuy]

I may be wrong but I think that there is only one pediatric cardiac surgeon in Alberta that serves the whole province and splits his time between Calgary and Edmonton. I heard this talking to one of the ladies involved in recruiting MDs to the Calgary Health Region.

 

It was two and a half years ago that I spoke with her though so I am not sure if things have changed in the interim.

 

Hopes this helps!

 

UBCGuy

[TimmyMax]

Hey,

 

I don't think Ottawa does any paed's heart surgery any more.

Really? I had no idea. Back in my 2nd year of medical school, London's lone(?) Paeds CV surgeon was lured away to Ottawa, effectively ending Paeds CV surgery in London at the time, which was a major coup. That'd be strange if the Ottawa program has since folded as well.

[ffp]

When I was a med student at U of A, there were 2 peds CV surgeons. To the best of my knowledge they are both still there (one yelled at me on the phone this morning )

 

Agree with the above posters - a bit more variety than adult cardiac surgeons, and not so threatened by interventionalists. Plus... your patients range from premature newborns to adult congenitals (the reason I got yelled attoday is that we were trying to transfer a 28yo patient for redo fontan and had not done the appropriate imaging first.. Oops).

[Satsuma]

I don't think Ottawa does any paed's heart surgery any more.

 

I am pretty sure they do. I know someone who's newborn had several heart surgeries last year.

[blinknoodle]

I am pretty sure they do. I know someone who's newborn had several heart surgeries last year.

 

They definitely still do some paeds cardiovascular surgery. I think they need to get the ok from the Toronto surgeons first - or at least present their planned cases to the network of consultants looking at paediatric cardiology across the province.