Benderson Family Heart Center | Observerships

Course objectives

Upon completion of the course, the participants will gain improved understanding of the pathophysiology and pathological anatomy of congenital heart disease. They will gain insight and will have been able to extensively observe and understand advanced surgical techniques used for repair of congenital heart malformations, including cardiopulmonary bypass techniques and variations, minimally-invasive exposure of the heart, robotic assistance, and hybrid techniques. Advanced ICU management strategies as well as new medications will have been discussed and their rationale understood. ECMO support techniques will be detailed.

Course requirements

Applicant qualifications: The Observership Course in Congenital Heart Surgery is designed for physicians who are currently in a Cardiac Surgery residency or Fellowship Program and/or are practicing cardiac surgeons who would like additional exposure to congenital heart surgery. With the application, please include:

1. Letter from the applicant's Chief or Director stating that his/her home institution is your sponsor.
2. Up-to-date Curriculum Vitae (in English)
3. Course duration is 2-4 weeks; there is a non-refundable fee of USD $3,000 per two weeks; four week stay, USD $4.500(meals and housing fees are not included and non-reimbursable)

Nomenclature and Pathology for Congenital Cardiac Disease
Wednesday, 4-6 pm; Cardiac Registry Lab
Course participants will receive weekly instruction for two hours in the study of congenital cardiac pathology. This course is supervised by Dr. Stephen Sanders, who has specialized in congenital cardiac pathology, and has access to the over three thousand specimens found in the Cardiac Pathology Registry at Boston Children's Hospital (“The Van Praagh collection”). The participants have the opportunity to study specimens from the extensive cardiac pathology registry, which covers the entire spectrum of congenital heart disease. Each week a separate lesion or group of related lesions is discussed with relevant autopsy specimens. Details of the anatomy, embryology, and surgical management options are discussed.

Peri-Operative Management of Congenital Cardiac Disease
Daily, 7:30 am; Cardiac ICU
Program participants will have the opportunity to attend daily working rounds in the cardiac ICU. These rounds are led by the cardiac ICU attending, and attended by the cardiac ICU trainees, cardiac surgery and cardiology residents, and the nursing staff. Decisions regarding indications and timing of surgery for cardiac disease, as well as peri-operative stabilization and management of patients, are discussed, and a management plan is formulated.

Combined Cardiology-Cardiac Surgery Preoperative Conference
Tuesday, 7:00am-8:30 am; Location: Byers A and B
Further training with a focus on decision making and management options occurs at the weekly cardiology – cardiac surgical combined conference. Surgical candidates are presented at this conference, including all anatomic and physiologic data. Catheterization data, echocardiograms, and any other imaging studies are presented. Decisions regarding surgical treatment and timing are rendered after faculty discussion. Staff surgeons, cardiologist, anesthesiologists and fellows (trainees) from each of the services attend this conference. All involved discuss the management plan for each case.

Didactic Teaching in Surgery for Congenital Heart Disease
Saturday 8-9 am
Participants attend one-and-a-half hour teaching session on Wednesday mornings from 7a-8:30a conducted by the attending staff in the Department of Cardiac Surgery. These rounds take place in the cardiac ICU at the patients’ bedside. While didactic in nature, these rounds provide an interactive forum for the participant to engage the attending staff on a variety of clinical topics and management issues. Each case is reviewed in depth and discussion includes indications for surgery, pre/intra/post–operative management. In addition, participants attend the didactic teaching sessions from 8a-9a on Saturday mornings, covering the full range of topics in congenital heart surgery and given by a staff cardiac surgeon.

Cardiac Surgery Mortality and Morbidity
Saturday, 9-11 am
Every Saturday, the week’s surgical activity is reviewed with the attending surgical staff. Case details, including interesting findings and complications are discussed. Specific technical and surgical issues relevant to each case are reviewed.

Cardiopulmonary Transplantation Conference
Wednesday, 8:30-9:30 am
A multidisciplinary clinical conference reviewing current and active patients on the transplant list. Evaluations and interpretation of data are performed for potential heart transplant candidates. Management of in-patient heart transplant recipients is discussed.

Peri-Operative Multidisciplinary M & M
Monthly; Wednesday (Fourth), 7:30-8:30am–Location: Garden Conference Rm.
Multidisciplinary Mortality and Morbidity conference attended by all participants within the entire Cardiovascular Program. Broad ranges of pertinent and timely issues that impact the care of patients are discussed. Representative clinical cases are presented to highlight the topic for discussion.

Work in Progress Research Meeting
Monthly: Wednesday (Second), 7:30-8:30am-Monthly; Location: Enders 344 Conference Room.
The “Work in Progress” series is an informal presentation of ongoing clinical and basic science research within the Cardiovascular Program. Presentations by visiting faculty are common and open to the participant.