This chapter discusses three things that characterize the modern hospital and cardiac services: the incorporation of enabling technologies, the adoption of databases, and the coalescence of institutions into networks. Each of these has impacted current cardiac surgical programs, as they matured from coronary bypass franchises to “full service stations.” Technological advances have given rise to entirely new treatment modalities, such as mechanical assist devices for heart failure, minimally invasive cardiac surgery, and endovascular approaches to structural heart disease. Internal and national cardiac surgical databases have been adopted that monitor, analyze, and disperse outcome data, to provide transparency and improve results. The coalescence of institutions into networks has given rise to efficiencies, allowing more support for primary care physicians in the community and the centralization of high-risk, resource-intense services, such as cardiac surgery.
Transcatheter TAVR ECMO Heart failure Cardiac surgery Databases Registries Network
Extracorporeal membrane oxygenation
Ventricular assist device
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