Programs and Courses
Courses & Electives
The first opportunity medical students have to participate in the Division of Cardiac Surgery is their third year. The undergraduate elective introduces you to pre-operative, operative and post-operative stages in managing patients with congenital and acquired diseases of the heart and great vessels as well as those requiring heart or lung transplantation.
Schedule an Elective
Pre-operative Evaluation
Students will gain experience in the assessment of patients referred for cardiac surgery. This will include attendance at multidisciplinary rounds, where all new referrals for pediatric cardiac surgery are discussed, and pertinent investigations reviewed. Adult patients referred for surgery are assessed in individual surgeons clinics as well as at combined cardiology-cardiac surgery rounds on a weekly basis. Students will have the opportunity to examine patients in the clinic where important history and physical findings can be reviewed with staff surgeon and resident. Students will gain an appreciation for the indications for surgery, alternate methods of treatment available and risk assessments for individual patients.Operating Room
Cardiac surgery by its nature is a very heavily operating room oriented specialty. Students will have ample opportunity in the OR to apply knowledge gained in anatomy, physiology and pharmacology as well as develop basic operating techniques such as skin closure and assisting. Emphasis will be placed on the following:
- Surgical anatomy of the heart, great vessels and mediastinum with emphasis on normal versus abnormal anatomy leading to pathophysiologic aberrations.
- Special investigations including cardiac catheterization, cine angiography, trasthoracic and transesophageal echocariography, CT and MRI scans.
- An introduction to the heart-lung machine (cardiopulmonary bypass) which supports circulatory and respiratory function during procedures on the heart as well as ECMO used occasionally for prolonged support, particularly of infants and children.
- Techniques of surgically treating acquired cardiac disease including valve repair and replacement, coronary artery bypass surgery, heart and lung transplantation, pacemaker and defibrillator implantation and repair of aneurysms and dissections of the thoracic aorta.
- Techniques for correcting the full range of congenital cardiac anomalies in patients from premature infants to adults with congenital heart disease.
- Intraoperative hemodynamic monitoring and the appropriate use of pharmacological support agents as well as mechanical support such as the intra-aortic balloon pump.
Post-operative Patient Management
Students will gain an appreciation of the multidisciplinary approach necessary for a successful outcome following cardiac surgery. Emphasis will be placed o the following.
- Principles and practice of post-operative Intensive Care Unit management stressing the assessment and preservation of normal function of the CNS, pulmonary, cardiovascular, renal, hepatic and G.I. systems. Students will have one dedicated day in the CVICU rounding with the intensivist on duty.
- Monitoring, surveillance rounds, laboratory and medical imaging tests for early detection of adverse trends or events and intervention to prevent or treat these events.
- Use of assisted ventilation, pharmacological agents, mechanical and renal support measures for postoperative patients.
- Clinic or office follow-up to appreciate the recovery and overall improvement in the patient's well-being following cardiac surgery.
- In general, students will be able to gain exposure to the above areas including direct participation with surgery, chest tube insertion and removal, and invasive line insertion. There should be the opportunity to participate in thoracic organ transplantation including donor procurement. Overall responsibilities will depend on the student's interest and skills. As cardiovascular disease accounts for more deaths and disability in North America than any other disease entity, this elective should be particularly valuable and instructive in the management of such problems.