[Perspectives of improvement of quality in cardiac surgery]

[The contradictory contexts of interdisciplinarity]

The benefits of interdisciplinary approaches in patient care, research and education are quite obvious and set the trend for more interdisciplinary structures. In order to achieve sustained success, however, there are numerous risks of interdisciplinary collaboration that have to be considered. Interdisciplinarity leads to an increasing degree of specialization and consequently to a greater experience of specialists in highly specific procedures. Nevertheless, this is accompanied by a loss of experience of those who do not perform these procedures anymore. Not least, due to the high specialization, the surgeon's profession is changing from generalist to specialist. Hence, the education of young physicians, students and researchers has to be adapted to this reality. It remains unanswered if these changes contribute to the decline in the number of applicants in surgery. In conclusion, the risks of the contradictory contexts of interdisciplinarity can be counteracted with simple principles of fair and cooperative partnership.

[Diminishing borders between cardiology and cardiothoracic surgery: quo vadis?]

Increasingly complex techniques in cardiovascular medicine lead to a competitive partnership between cardiology and cardiac surgery. Common challenges will arise in the fields of coronary heart disease, heart valves, heart failure and rhythm therapy. For instance, coronary revascularization in acute myocardial infarction is no longer considered to exclusively be an interventional option. In comparison, the implantation of heart valves is increasingly carried out by cardiologists using interventional techniques. The latest designs of sutureless valves try to combine the benefits of conventional and transcatheter heart valves. Heart failure is the most common reason for hospital admission and thus an important therapeutic target for cardiology and cardiac surgery. New approaches in diagnostics, heart assist devices and cellular therapy meet this challenge.

CONCLUSION

In the future only a sensitive and transparent collaboration across transsectoral borders will offer optimal therapy in cardiovascular medicine.