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Innovation and Excellence: Changing to Prevail The Brazilian Cardiovascular Surgery

Walter J. Gomes

DOI: 10.5935/1678-9741.20130069

Labor omnia vincit - Work conquers all
Prof. Dr. Euryclides de Jesus Zerbini


Following in the footsteps of our predecessors, the Brazilian Society of Cardiovascular Surgery (SBCCV) has persevered in its quest for excellence, becoming a role model for other Specialty Societies due to its achievements and the progress it has made in both the public and the private sector. However, there are still some great challenges ahead which will be faced and overcome with the usual determination and resilience as well as the spirit of unity, cohesion, and harmony that are characteristic of the cardiovascular surgery community.

Technological and scientific advances and innovations have refreshed our specialty and placed cardiovascular surgery in the spotlight once again. Those achievements in all areas have enabled us to plan farther and reach greater heights.

The insertion of Brazil amongst developed nations was consolidated through the process of internationalization. Partnerships with the European Association for Cardio-thoracic Surgery (EACTS) and the Sociedad Latinoamericana de Cirugía Cardiovascular y Torácica (SLCCT) have allowed us to strengthen the scientific base of our Congress, counting on the presence and interaction of the most respected surgeons from every corner of the world. Several subject matters are currently being negotiated, such as a Continuing Education course, exchange of surgeons and residents, joint symposiums, multicenter studies, cooperation of scientific journals, among others. Recently, a partnership has been extended to the American Association for Thoracic Surgery (AATS).

The SBCCV Congress has continuously grown in number of participants as well as exhibitors, being recognized as one of the largest national events of this specialty in the world. The newly incorporated multi-professional modules, such as the Perfusion, Nursing, and Physiotherapy in Cardiovascular Surgery Symposiums, have provided the opportunity to gather every professional involved in caring for cardiovascular patients in one place, allowing their conduct to be updated and unified. The inclusion of the Academic Congress in Cardiovascular Surgery aims to attract the new generation, to gather, inform, and form what will be the future of this Specialty as well as to motivate the creation of new Cardiovascular Surgery Interest Groups throughout the country. The new Hands-on practical module, directed by Prof. Gilberto Barbosa, has been a great success due to its straightforward, practical, and educational format.

Success today is contingent on building partnerships and joining efforts. Since the industry holds the technology we need to continue providing the best care for our patients, the SBCCV has strengthened those ties, in a fully ethical and transparent manner. By incorporating new technologies, innovative surgical techniques and implantable devices have widened the scope of the cardiovascular surgeon practice. Therefore, training partnerships are necessary to acquire the abilities and expertise needed to ensure excellent results. Besides training, these programs offer medical education, access to scientific information, and, subsequently, multicenter trials which will have to include Brazil. In addition, the training benefits residents and perfusionists.

There is a need to focus on scientific advances. Partnerships with international societies and the industry have helped, but they need to advance faster. In addition, university involvement in scientific contributions should be emphasized in order to bring accumulated knowledge to cardiovascular surgeons spread throughout a country of continental dimensions with different regional realities.

At the moment, following the examples of the United States and Canada, it is mandatory to restructure the Cardiovascular Surgery Training Program by abolishing the previous full requirement of General Surgery and giving greater emphasis to scientific training, research, and writing of scientific articles. Besides training good surgeons, it is imperative to train researchers in order to continue developing this specialty.

Institutional partnerships have been fruitful, with the SBCCV working in harmony and with the same objectives to develop joint projects with the Brazilian Society of Cardiology (SBC), the Brazilian Medical Association (AMB), the Heart Failure Department of the SBC (DEIC), the Brazilian Association of Intensive Medicine (AMIB), the Brazilian Society of Hemodynamics and Interventional Cardiology (SBHCI), and the Brazilian Society of Pediatrics (SBP), among others. This type of work emphasizes the sharing of knowledge and experience across specialties so that the patient is offered the best therapeutic decisions with the greatest benefits. To this end, the multidisciplinary approach (the Heart Team) is encouraged by specialty societies and, in particular, by the SBCCV.

In addition, the SBCCV has also made efforts to work in collaboration with government agencies, such as ANVISA, in the Technical Chamber of Drugs; the Ministry of Education, in the Federal University Teaching Hospitals Project; and the Ministry of Health, in the following projects: advice on orthosis and prosthesis; the National Registry of Cardiovascular Surgery; and the National Program for the Surgical Treatment of Children with Congenital Heart Disease, which aims to reduce high mortality rates due to lack of access to surgical treatment. The meetings have focused on a range of issues: the need to implement a list of sequential procedures to be paid by SUS, as previously agreed; the review of the codes in the SUS list; the inclusion of new devices and materials for cardiovascular surgery in the SUS; and the challenges of pediatric cardiovascular surgeries in Brazil, where the number of procedures is insufficient, leaving two-thirds of the patients in need without surgical treatment.

Our scientific journal, the Brazilian Journal of Cardiovascular Surgery (BJCVS), under the editorship of Prof. Dr. Domingo Braile, earned a higher impact factor, reflecting the capability and the quality of the production of Brazilian cardiovascular surgeons. The Scientific Bulletin keeps cardiovascular surgeons updated by selecting the best papers published in the given period thus contributing to better decision-making in the treatment of patients.

Since the goals of the SBCCV have come closer to those of their members, it has reinforced the need to defend the professional dignity of cardiovascular surgeons applying fair fees by continuing to support the negotiations with private payers. Unity has been our strength, our biggest triumph. Surgeons no longer see their colleagues as competitors, but as allies in the struggle to regain professional dignity.

The National Registry of Cardiovascular Surgery is being implemented and it will place us on an equal footing with other specialty societies worldwide as well as Europe, the United States, and Japan. It will allow us to understand our reality and provide subsidies to improve the quality of our results.

We also have a new home! The recent acquisition of much larger premises to fit the growth SBCCV experienced in the last few years will allow us to better match demands. Furthermore, it will make more resources available for training and continuing education, with an area for the Hands-on training and an auditorium with capacity for 40 people.

There is also recognition for the teamwork that produced the results described above. All these accomplishments and achievements would not have been possible without the hard work, idealism, and enthusiasm of dedicated individuals, members of the Board and of our community, who contributed to every single part of this report by letting collective interests prevail over their own. Throughout these years of involvement, we have had the opportunity to live with, admire, and learn from the work of those individuals who have made the SBCCV stronger, more robust, and more respected. We have learned from their ideas, prominent views and wisdom, and we have accumulated experience in dealing with antagonisms and controversies, solving conflicts, and shaping new leaders.

Finally, I would like to express my appreciation for the honor of being president of the SBCCV. In this term, marked by several trips, conversations and exchanges of information, I have learned to respect and admire even more the cardiovascular surgeons scattered around the country, who not only work many times in adverse conditions without overlooking patient care and their responsibility or shirking long shifts, day and night, but who also do this job with an incredible amount of love, dedication, and passion to their profession and their patients. I believe this is what makes cardiovascular surgeons stand out from the rest.

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