Cardiovascular Medicine

3 pages, 208 KB

Open AccessCommunication

Menarini Prize 2006

by M. Zuber

Cardiovasc. Med. 2006, 9(11), 404; https://doi.org/10.4414/cvm.2006.01209 - 29 Nov 2006

Viewed by 10

In 2002, the Working Group for Echocardiography of the Swiss Society of Cardiology Awards, with the support of Menarini Switzerland, created a prize to promote echocardiography and support young cardiologists in Switzerland [...] Full article

2 pages, 227 KB

Open AccessInteresting Images

Trisomie 21 et Malformation Cardiaque

by Bouchardy J., Sekarski N. and Delabays A.

Cardiovasc. Med. 2006, 9(11), 402; https://doi.org/10.4414/cvm.2006.01211 - 29 Nov 2006

Viewed by 10

Abstract

La trisomie 21 ou syndrome de Down est l’anomalie chromosomique la plus fréquente à la naissance[xxx] Full article

2 pages, 610 KB

Open AccessInteresting Images

Atypische VerÃ¤nderungen des Terminalen QRS-Komplexes als Isoliertes Zeichen Eines Akuten RCX-Verschlusses

by Beatrice Hirt Moch, Gert Wachter and Stefan Christen

Cardiovasc. Med. 2006, 9(11), 400; https://doi.org/10.4414/cvm.2006.01210 - 29 Nov 2006

Viewed by 12

Abstract

Ein bisher gesunder 61jähriger Raucher mit positiver Familienanamnese stellte sich mit seit zehn Stunden zunehmenden epigastrischen Schmerzen mit Ausstrahlung in den Unterkiefer und in beide Arme vor [...] Full article

7 pages, 1436 KB

Open AccessEditorial

Valve Prostheses in Cardiac Surgery: Categories and Particularities

by René Prêtrea, Maurice Combera, Alexander Kadnerc, Rolf Jennic and Michele Genonib

Cardiovasc. Med. 2006, 9(11), 393; https://doi.org/10.4414/cvm.2006.01206 - 29 Nov 2006

Viewed by 14

Abstract

The last decade has witness a proliferation of new cardiac valve prostheses. Similarly, the indications to operate patients with valvular heart disease have changed significantly toward a more liberal resort to surgery. The choice of a prosthesis is no longer exclusively made on [...] Read more.

The last decade has witness a proliferation of new cardiac valve prostheses. Similarly, the indications to operate patients with valvular heart disease have changed significantly toward a more liberal resort to surgery. The choice of a prosthesis is no longer exclusively made on the patient’s age but takes into account many secondary factors. Most of them are directly related to the patient’s characteristics. Some of them, however, are related to the surgeon’s expertise and the prosthesis’ characteristics. This overview aims at presenting the most commonly used prostheses and at presenting their most salient properties. Full article

10 pages, 254 KB

Open AccessEditorial

Betreuungskonzept für die Schweiz

by Erwin Oechslin

Cardiovasc. Med. 2006, 9(11), 383; https://doi.org/10.4414/cvm.2006.01208 - 29 Nov 2006

Viewed by 12

Abstract

The improved survival of children with complex congenital heart defects (CHD) into adulthood and the expansion of the population of adults are the result of great advances in medicine including congenital heart disease surgery, anesthesiology, intensive care and diagnostic imaging during the last [...] Read more.

The improved survival of children with complex congenital heart defects (CHD) into adulthood and the expansion of the population of adults are the result of great advances in medicine including congenital heart disease surgery, anesthesiology, intensive care and diagnostic imaging during the last 50 years. The population of adults with CHD is heterogeneous due to the introduction of different types of repair and their modification during the last decades. However, most of them are left with residua and sequelae. Their congenital heart defects are repaired and not fixed: these patients are not cured. There is an estimate of approximately 20 000 adults with CHD in Switzerland, 11 000 of them are at moderate or high risk for reinterventions (ie conduit failure), arrhythmias, endocarditis, heart failure, or premature death. The discrepancy is obvious between the available resources and the increasing needs for delivery of appropriate care to adults with CHD. Adult health care systems are challenged worldwide: they are not prepared to deliver high quality care to the ever increasing number of complex patients because the increasing needs for structural and personnel resources have been neglected for many years. There is a lack of expert caregivers. General education and training in cardiology does not cover the knowledge and expertise required to provide specialised care to adults with CHD: the anatomy, morphology, pathophysiology and the surgical procedures are complex. Many pediatric cardiologists have become increasingly involved with adults with CHD as their pediatric patients have aged. Pediatric cardiologists are trained in CHD, however, they do not have enough or no experience or training in comprehensive adult care, eg acquired disease, reproductive medicine, etc. Most units rely on an extended role for pediatric cardiologists who work in conjunction with “interested” adult cardiologist. There is an urgent need to improve this situation by implementing educational requirements. There are three levels of caregivers. Primary caregivers or cardiologists without additional training and exposure to congenital heart disease provide level 1 care. Caregivers on level 2 are cardiologists with a “real interest” in congenital heart disease. In addition to their normal training, they spend the equivalent of 6 months of full-training in a specialist centre, they attend >20 outpatient clinics at a specialist centre over a period of 2 years and maintain their skills by direct association with a supraregional or specialist centre. Cardiologists with a level 2 training are working in regional adult congenital heart disease clinics, they serve for a population up to 2 million and they will be the backbone for the provision of care to the growing population. Specialist cardiologists with level 3 training may come from pediatric cardiology or adult cardiology. Both of them require at least a 12 to 18 month training in a high volume specialist centre (supraregional referral centre) for adults with CHD; adult cardiologists with a level 3 training should have an additional year of pediatric training in a centre with active congenital surgical and interventional program. Patient care, education and research are the three pillars of a supraregional referral centre which serves for a population between 3 and 10 million, which is fully equipped and which provides high volume care to maintain skills and expertise of both the cardiologists and congenital heart surgeons. Amultidisciplinary team approach in patient care, education and research is fundamental to achieving high standard and covering the wide and spectrum of complex co-morbidities in adults with CHD. A close collaboration (networking) among the 3 level of care is crucial. Importantly, a close integrated collaboration with the pediatric cardiologists is fundamental. The provision of care is based on the level of training. Patients at low risk (simple defects without major residua/sequelae) can be followed by a cardiologist providing care on level 1. Patients at moderate or high risk should be followed by a cardiologist with a level 2 or 3 training. Congenital heart disease is a chronic disease from fetal life until adulthood. Education of the professionals, of the patients and of the public is the key to truly extend the outstanding results of pediatric cardiology and congenital heart surgery into adulthood. It is our ethical responsibility to provide the same quality of care as we do to patients with acquired cardiovascular diseases. We must validate the investment made in children with CHD. We provide excellent care to children with CHD – we don’t want them to be second class citizens when entering the adult health care system. Full article

6 pages, 395 KB

Open AccessEditorial

Lifelong Specialised Care of Adults with Congenital Heart Disease a Luxury or State of the Art?

by Pedro Trigo Trindade

Cardiovasc. Med. 2006, 9(11), 376; https://doi.org/10.4414/cvm.2006.01207 - 29 Nov 2006

Viewed by 12

Abstract

The medical and surgical advances which have occurred in the second half of the twentieth century in the diagnosis and treatment of congenital heart disease allowed the survival of an increasing number of patients to adulthood. After an intervention or cardiac surgery many [...] Read more.

The medical and surgical advances which have occurred in the second half of the twentieth century in the diagnosis and treatment of congenital heart disease allowed the survival of an increasing number of patients to adulthood. After an intervention or cardiac surgery many of these patients consider themselves “cured”, but most of them will have residua and sequelae which require lifelong surveillance. The adult cardiologist dealing with this patient population faces many challenges, such as deciding about the indication and the timing for a re-intervention and/or a re-operation, the treatment of arrhythmias and of systemic ventricular dysfunction, and the prevention of endocarditis and of pulmonary vascular disease. Furthermore, these patients have special needs with respect to reproduction, employment and insurability. The purpose of this article is to emphasise the importance of a specialised lifelong follow-up of adults with congenital heart disease in order to provide optimal care. Full article

2 pages, 227 KB

Open AccessEditorial

Angeborene Herzfehler: Lebenslange, Spezialisierte Betreuung für eine Chronische Erkrankung

by Oechslin Erwin

Cardiovasc. Med. 2006, 9(11), 1212; https://doi.org/10.4414/cvm.2006.01212 - 29 Nov 2006

Viewed by 5

Abstract

Die angeborenen Herzfehler, die häufigste angeborene Erkrankung, sind eine Erfolgsgeschichte der Medizin: Während vor 60 Jahren nur 20% der Kinder mit komplizierten Herzfehlern erwachsen wurden, erreichen heute dank der grossen Fortschritte in der Medizin über 90% das Erwachsenenalter[...] Full article

Journal Menu

Journal Browser

Cardiovasc. Med., Volume 9, Issue 11 (11 2006) – 7 articles

Further Information

Guidelines

MDPI Initiatives

Follow MDPI