From the President's Desk
Vision
19 May 2025
(Last updated: 19 May 2025 09:44)
From the President’s Desk
Vision
Minimally invasive surgery (MIS) in cardiac surgery across Great Britain and Ireland is not where it could be. At the SCTS we want to advocate for and help drive the change. MIS, combined with Enhanced Recovery After Cardiac Surgery (ERAS-C), offers patients faster recovery, less morbidity, a better experience, excellent outcomes and healthcare system efficiencies. Achieving this vision requires more than technical skill. It requires a culture of embracing change, collaboration, and innovation.
This is why our partnerships with patients, the British and Irish Society for Minimally Invasive Cardiac Surgery (BISMICS), the Association for Cardiothoracic Anaesthesia and Critical Care (ACTACC) and other stakeholders are so important. It is about collectively sharing best practices, improving training, and using technology with care so that patients receive the best outcomes. We are also grateful for industry support when it aligns with our vision.
Ancona: Learning and Collaboration in Practice
Recently a joint SCTS & BISMICS group visited the Edwards Lifesciences Centre of Excellence in Ancona, Italy. Our team comprised SCTS Education Secretary Debbie Harrington, SCTS President Elect Enoch Akowuah, and BISMICS Chairman & President-Elect Ranjit Deshpande and myself. We explored advanced cardiac MIS techniques and ERAS-C protocols. The unit led by Professor Marco Di Eusanio has developed great experience in this area with hundreds of patients successfully undergoing mitral and aortic valve surgery via a right transaxillary/uniportal approach as well as other innovative practices.
Edwards played a key role in making this educational visit possible. Our focus was not just on technical skills but also on how to integrate these approaches into UK practice.
As a thoracic surgeon the minimal access approach is very familiar. It is a direct vision approach, and the excellent use of the surgeon’s head-camera meant the whole team also had a great view. It was inspiring to watch a master surgeon and their team at work. Slick femoral cannulation and set-up. Outstanding skill and unspoken teamwork, with the silent, fluid passing of instruments. Every person knew their role in a seamless flow. To see the consultant surgeon and team move into and out of ‘the zone’, our special surgeon space, was moving.
A Tree with a Medical story
On my journey to the hospital, I saw a remarkable tree. Its golden, trumpet-shaped flowers were striking, and it had a rich fragrance which changes through the day, being most in the evenings to attract insects, and in this case a passing traveller from the UK. A search found it to be a Brugmansia, Angel’s Trumpet, a plant both beautiful and storied. Brugmansia is known for its vivid blooms and fragrant embrace, yet its significance runs deeper.
In South American cultures, Brugmansia has long been revered, a healer, a guide, a symbol of wisdom. Its leaves and flowers, potent with medicinal compounds, were used to ease pain, calm asthma, and open the door to dreams. Derivatives include Scopolamine, atropine, and hyoscyamine. Some varieties are used for spiritual purposes and invoking visions.
London Core Review: Leadership, Innovation, and SCTS Vision
The day after returning from Italy, I spoke at the London Core Review at the Welcome Collection. Growing up in North London, this is an area always full of nostalgia, often around childhood visits to my father at work and later exploring as a teenager.
The meeting is led by Aziz Momin from St.George’s. I have admired this important educational meeting, now in its 15th year, and was honoured to share the session with:
- Professor Pieter Kappetein, chief medical officer at Medtronic who discussed the latest innovations in cardiac surgery.
- Professor David Taggart, from Oxford University who examined the evidence around percutaneous coronary intervention against coronary artery bypass grafting (PCI v. CABG), emphasising the importance of accurate interpretation of data, bias and the use of meaningful outcome measures, particularly long-term results.
My talk was to share insights from my leadership journey, the role of SCTS in advancing surgical practice, supporting members, and advocating for better patient care. The session then went onto an enjoyable interactive heart MDT led by Dr Iqbal Malik, showing the range of decisions and the value of collaborative decision-making.
New Vision in the Operating Theatre
Back at my own hospital, I performed a VATS lobectomy using the ENDOEYE an advanced 3D thoracoscope from Olympus. Even on this first use, the improved magnification and 3D clarity made a difference.
Even though our team is experienced with MIS and ERAS, the new insights from Ancona were already nudging my practice, and I made small changes to operating room expectations. To me, it felt as if there was an immediate improvement; I also noted that the case finished a little earlier; and with the great reward for patient and surgeon, no air leak!
I also worked with our plastic surgery team on an interesting chest wall resection, guiding a trainee through the procedure. This was a reminder that training is not just about immersive courses for consultants, but also about day-to-day mentorship and direct supervision.
Strengthening the SCTS Team
As part of our commitment to maintaining a strong administration team, our leadership group also interviewed for a new Human Resources (HR) professional this week. Leading SCTS is also about running an organisation, with much learning about corporate and charity governance. Ensuring compliance with HR best practices and providing a supportive environment for our staff is essential for the continued success of SCTS.
The weekend
After 2 weekends back-to-back on call and a trip to Italy, a long family walk in Norfolk by sea and through woods restored some calm and space away from a busy world: a different vision.
Thank you to our members.
My appreciation goes to our SCTS administration team and all our volunteers for their dedication and hard work.
Warm regards,
Aman S Coonar
President, Society for Cardiothoracic Surgery (SCTS)
Reviewed and edited by Sri Rathinam, SCTS Communications Secretary.
Feedback (good or bad) is strongly encouraged and gratefully received. Please send to SCTS administrator Emma Piotrowski at emma@scts.org or direct to aman.coonar@nhs.net
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