Lipid & Atherosclerosis Society of Southern Africa (LASSA)

The Lipid and Atherosclerosis Society of Southern Africa (LASSA) remains affiliated with both the South African Heart Association (SA Heart) as a Special Interest Group (SIG) and with the Society for Endocrinology and Metabolism and Diabetes of South Africa (SEMDSA).

LASSA remains a small group with its orientation as an academic body with an emphasis on  teaching hospitals but covers a wide area of interest in inherited disorders of lipid and lipoprotein metabolism,
atherosclerosis, nutrition, epidemiology and pharmacotherapy.  There is concern that the support for teaching and research in the fields of interest of LASSA are diminishing, especially at a time that atherosclerosis is acknowledged as one of the leading causes of morbidity and mortality in the country. Expertise in severe dyslipidaemias remains mainly at a few teaching hospitals where facilities and staff are rapidly shrinking.

The LASSA meetings are held in conjunction with SEMDSA every two years and meetings or sessions are intended for the interval year along with the SA Heart meetings. The LASSA meeting for 2006 was postponed because SEMDSA hosted the International Diabetes Federation meeting in Cape Town
in December 2006.  The LASSA meeting planned in Bloemfontein in conjunction with SEMDSA in the winter of 2007 was also postponed because of practical problems attending during school holidays for most members. The next conjoint meeting with SEMDSA is planned for April 2009 to retain the alternating meetings with SA Heart. 

Apart from feedbacks from academic meetings and providing assistance with clinical problems, there was little other activity from LASSA. Consideration has been given to establish a more formal networks of clinics and to put together an academic course on lipidology.

AD Marais, Groote Schuur Hospital & University of Cape Town
FJ Raal, Johannesburg Hospital & University of Witwatersrand

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Nuclear Cardiology Group

Nothing to report.

Cardiac Arrhythmia Society of Southern Africa (CASSA)

This report is tabulated on behalf of the Executive Committee, who I wish to acknowledge and thank for their various contributions through the year, Prof A Okreglicki is secretary, whom I wish to thank for his very accurate and timeous minutes and ‘to do lists’. Ms Daniels took over the defunct treasure over a year ago and has sorted it out including our relationship with the SA Revenue Services and auditors. Andrew Thornton is editor of the news letter which is now published as part to the general SA Heart Association newsletter which is circulated in the SA Heart Journal. The other members of the Exco are Prof R Scott-Millar, Dr IWP Obel, Dr A Stanley, and Dr D Milne, a co-opted member. The industry representatives are Mr. W Strannix whom I particularly wish to thank for his organization and sponsorship for our quarterly teleconferences and Ms L Coetzer, whom I particularly wish to thank for her assistance in organization and accreditation of the CASSA road show.

The CASSA road show has been a significant fraction of our activities for the past year, a project initiated in the year before to provide a course in ECG interpretation and arrhythmia management aimed at Health Professionals outside of mayor centres. The Northern Road show has had 6 meetings to date: Witbank and Rustenburg (2006), Nelspruit (24 February), Bloemfontein (21 April), Klerksdorp (9 June) and Polokwane (18 August) in 2007. The final venue of this road show will be in Gabarone in early 2008. The Southern Road show had meetings in Worcester (2006), East London (24 March), Mossel Bay, George, Port Elizabeth and Cape Town (20 October 2007) with further meetings planned for Grahamstown, Knysna and Hermanus. Overall this outreach programme has been well received and successful, and will probably continue in the new year in a somewhat modified format in the major metropolitan areas.

Other educational activities of CASSA have included the ECG quiz in the SA Heart Journal thanks to Prof A Okreglicki, and a series of 5 clinical electrophysiological meetings initiated and organized by Dr Andrew Thornton in Gauteng over the past year. This latter meeting has embraced cardiologists in training at the University of the Witwatersrand group of teaching hospitals, has also been well-received. Obviously the CASSA symposium organized at this congress is part of our educational effort, which we will continue to have annually, and I am happy to say that the 2007 symposium has once again provided relevant sessions for practitioners in this area of interest.

The device industry and Medtronic in particular has recognized the large need for education in device follow-up and re-programming in the South African situation. There is a need for an accredited course together with some sort of examination and certification for this. CASSA fully endorses this project.

CASSA continues a process of accreditation, under the direction of Prof R Scott Millar. Initially an invitation and questionnaire was submitted to the members of the Exco, following which they have been asked to submit case reports on various aspects of electrophysiology, and certain minimum criteria of competency have been established, base loosely on the ACC / AHA Clinical Competency Statement on EP procedures and training initially published in 2000 and recently updated in Circulation 2006;114:1654-68. This process has now been extended to all cardiac practitioners outside of Exco. Different levels of competency are envisaged, e.g. a practitioners may be credited for full invasive electrophysiology, non-invasive electrophysiology, ICD implantation, bi-ventricular pacemaker implantation, and AV ablation independently. It is hoped that this list of competent operators will be recognized by both the public and funders.

Fees for electrophysiology procedures have long been the Cinderella sister of fee negotiation, but I am happy to report the Anthony Stanley in his role as chairman of the Private Practice standing committee of the SA Heart Association as well, has polled operators and is trying to structure some uniformity in the billing practices for various electrophysiology procedures in the country and it is hoped in so doing, some rational fee structure negotiation will be easier in the future.

CASSA continue to participate in various registries. The electrical part of the SA Heart Association Cathlab registry was originally designed by Prof R Scott Millar, and future follow-up modification will be undertaken by Dr Andrew Thornton. The ARVC registry originally initiated by Prof Bongani Mayosi was dormant for a while but has been re-activated by Dr Brian Vezi and has already collected a significant number of cases in the Western Cape and KwaZulu Natal, and will be extended to the rest of the country shortly, I understand. CASSA is particularly interested in a registry of ICD implantations and Dr David Milne has been tasked with this.

One of CASSA’s mission statements is support and education for lay people. . An organization called “PACE” (Prevent Arrhythmic Cardiac Events) has been formed in Cape Town and has been presided over  be a remarkable woman, the mother of a child who survived sudden cardiac death to ARVC, Lusan Luscombe. A number of counselors have been trained to support survivors of sudden cardiac death and OCD recipients in Cape Town. Lusan recently traveled to Gauteng to meet with Gauteng specialists, as it is planned to extend the activities of PACE to Gauteng. CASSA continues to support activities of PACE both in principle and financially, e.g. we recently sponsored her attendance at “Heart Rhythm Congress 2007” in Birmingham (29-31 October 2007), where she spoke on “International Partnerships”.

I must acknowledge the support of industry in CASSA activities, and in particular Medtronic, Biosense-Webster, and Sanofi-Aventis. CASSA’s income is otherwise derived from member’s subscription and proceeds of the annual congress, and without support of industry, in particular in relation to the road show, a number of our activities would not be feasible.

Regrettably I have to inform you that the CASSA website remains non-functional for a number of reasons, mainly because we were let down badly by the design/implementations company. I can only promise that this task is now prioritized in our agenda and it will be running in January.

In concluding, I wish to acknowledge the support of the membership, but would urge current members to become more involved in one or other of CASSA’s activities as you can see from the above report the same names recur in regard to various activities due to our small numbers. In the same vein, I would urge members to try and recruit new members and so grow our status and productivity.

Dr RM Jardine
President, CASSA

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The Paediatric Cardiac Society of South Africa

1. INTRODUCTION
The Paediatric Cardiac Society of South Africa (PCSSA) is a voluntary association of paediatric cardiologists, cardiac surgeons, cardiac anaesthesiologists and paediatricians, all with an interest in children with heart problems.  The objectives of the Society are to improve quality of care for children with congenital and acquired heart disease though promoting research and supporting education and training of children’s heart specialists.  PCSSA is the primary advocacy group for children with heart disease in South Africa. 

2. EXECUTIVE COMMITTEE
President: Christopher Hugo-Hamman, Vice President Steven Brown, Secretary Deliwe Ngwezi, Treasurer Steven Brown, Without portfolio - Jeff Harrisberg, John Hewitson, Ebrahim Hoosen
                         
3. GUIDELINES ON ECHOCARDIOGRAPHY IN CHILDREN
The guideline entitled, “Standards of Practice for Echocardiography in Children in South Africa” has been submitted to SA Heart and South African Paediatric Association for comment and publication in the Journal of the SA Heart Association.   

4. CHILDREN’S HEART DISEASE MULTIMEDIA EDUCATION PROGRAM
PCSSA has launched a “Children’s Heart Disease Multimedia Education Programme”.  Our aim is to provide reliable and accurate multimedia and online resources for the dissemination of information on congenital and acquired heart disease in children. This web based project would initially target patients, family members and grow to meet the needs of medical and allied professionals. The programme will address the unique needs of South Africans dealing with cardiac disease in children.  To this end, resources aimed at patients and their families will place emphasis on providing a multilingual platform to cater for the diverse languages spoken in South Africa. After advertisement to our membership, Dr Deliwe Ngwezi has been appointed Director of this exciting project.

5. RECOMMENDATIONS FOR CARDIAC CATHETERIZATION IN CHILDREN
In further recognition of our professional and ethical responsibilities, the PCSSA considered the development of guidelines for cardiac catheterisation in children in South Africa.  The scarcity of Paediatric Cardiologists in our country and the limitations on public sector financial resources compared with Asia, Europe and north America, makes a strong case for the development of such guidelines.  The PCSSA, with guidance of Dr Shakeel Qureshi, hosted a seminar on the development of these guidelines in Stellenbosch on the 28th of October 2006.  Our thanks to Dr Jeff Harrisberg for convening the programme and to PARAGMED for there sponsorship of this meeting.  The proceedings of this meeting ands the Recommendations are still in preparation. 

6. NETCARE PAEDIATRIC CARDIAC SYMPOSIUM: OCTOBER 2006
Our annual scientific symposium was held in Somerset West between Sunday 29 October and 1 November 2006 within and parallel to the Annual Congress of SA Heart Association.  The Symposium was organised by Prof Steven Brown.   There was an excellent scientific faculty with University of Witwatersrand graduate and echocardiography giant Prof Norman Silverman retuning to South Africa from San Francisco, the internationally acclaimed interventionist Prof Ziyad Hijazi visiting from Chicago and the outstanding scientist and surgeon, Prof Emeritus at Great Ormond Street Marc de Leval, from the United Kingdom and Dr Shakeel Qureshi, Consultant Paediatric Cardiologist at the United Medical and Dental Schools of Guy’s and St Thomas’ Hospitals, London.  Now in its 5th year, we are grateful for sponsorship received from NETCARE toward the Symposium.  That sponsorship was passed directly to the SA Heart Congress Committee from PCSSA.  It is with regret that we record that to date, 1 year after this Congress, the PCSSA has still to receive a share of the profit recorded at this Congress.  This issue, together with the status of the Paediatric Cardiac Society at the Annual Congress of SA Heart and in SA Heart, is a matter presently being addressed through the President of the SA Heart Association.  

7. PAN AFRICAN SOCIETY OF CARDIOLOGY/KENYAN CARDIAC SOCIETY CONFERENCE ON “HEART DISEASE, DIABETES AND STROKE IN AFRICA”
The PCSSA arranged and financed the paediatric programme for the “First Pan-African meeting on heart disease, diabetes and stroke in Africa”.  This conference was held under the auspices of the Pan African Society of Cardiology (PASCAR) and Kenyan Cardiac Society in Nairobi between 13 and 16 May 2007.  Speakers in the meeting included John Hewitson, Jeff Harrisberg, Phillip Bonhoffer from Great Ormond Street, James Wilkinson from the Royal Children’s Hospital in Melbourne and Anna Olga Mocumbi from Mozambique. The meeting was well attended with around 200 delegates from across Africa.  To address intra-Africa collaboration, in an extra ordinary meeting, a Paediatric chapter of the Pan African Society of Cardiology was established with its first aim the creation of an internet based “African paediatric heart network”.  The organizers hope to make this meeting a Biennial with the next in 2009 at a venue to be announced. John Cushing the CEO of the international charity “Children’s HeartLink” attended the meeting and we are grateful for their sponsorship.  We also acknowledge with thanks the generous sponsorship and support received from Mike Howe-Eley of Medtronic and Gary Pakes from Paragmed.

8. PAEDIATRIC INTERVENTIONAL CARDIAC CATHETERISATION WORKSHOP, SUNNINGHILL HOSPITAL 6TH – 7TH AUG 2007
In August 2007 the Paediatric Cardiac Society of South Africa, ran a workshop on interventional procedures in congenital heart disease.  Dr Ziyad Hijazi from Chicago demonstrated and tutored participants on complex and challenging congenital cardiac conditions.  Ziyad Hijazi is well published in interventional procedures, he coordinates and runs the annual PICS (Paediatric Interventional Cardiac Symposium) meeting - the largest interventional meeting on congenital heart disease held in the world.  The Paediatric Cardiac Society thanks Netcare, all individual donors as well as the medical companies (Paragmed, Bracco, Boston Scientific and Statmedical) who generously contributed financially as well as all the individuals who gave their time towards making this meeting a success.  Most especially we acknowledge the massive effort made by our colleague Jeff Harrisberg. 

9. WORKSHOP ON PAEDIATRIC CARDIAC SERVICES IN SOUTH AFRICA –22 NOVEMBER 2007
We believe the PCSSA should take a leading role in setting objectives for the development of heart services for children in South Africa.  To this end we will host a workshop on 22 November in Sun City.  The workshop will have the following outputs:

1. A document describing the burden of cardiac disease in children and their needs for cardiac interventions and surgery.
2. An audit of private and public cardiac services for children in South Africa.
3. A description of the institutional requirements necessary to run a successful paediatric cardiology and cardiothoracic service in the country and within regions.
4. A presentation of the shortcomings in present service delivery.
5. Presentation of the manner in which services ought to be developed.
6. Create a platform through which we can "lobby" for the improvement of services particularly in the state sector.

Each unit (public and private) in South Africa has been invited to actively engage and participate in this project and make a formal submission in this regard.  This is the first countrywide project of this nature undertaken by PCSSA and probably our most important initiative to date.

10.  NETCARE PAEDIATRIC CARDIAC SYMPOSIUM - 21 TO 25 NOVEMBER 2007
PCSSA was invited to join the South African Society for Cardiac Intervention (SASCI) and the Cardiothoracic Society of South Africa in organising this year’s annual SA Heart Congress entitled “Heart 2 Heart”, which will be held at Sun City from 21 to 25 November 2007.  Dr Jeff Harrisberg has represented us on this committee and Convened the Paediatric Programme.  We regret that in the Congress material and announcement the PCSSA is not given credit as an organiser of this event. 

11. WORLD CONGRESS OF PAEDIATRIC CARDIOLOGY AND CARDIAC SURGERY 2013
PCSSA proceeds with our bid for the 2013 World Congress.  The Chairman of the Steering Committee for 2013, Dr Horatio Capelli of Argentina, visited Cape Town during the World Diabetes Conference in early December 2006 as a guest of PCSSA and the Cape Town International Convention Centre.  He was well impressed with our destination. 

Chris Hugo-Hamman and Susan Vosloo travelled to Washington in May this year to present a bid to the Steering Committee for the World Congress.  Each member had received by courier in the preceding week our bid document and CD Rom on Cape Town, the Cape Town International Convention Centre and on South Africa.  We gave a thirty minute presentation in Washington DC on 5 May 2007.  The bid was well received and feedback has thus far been enthusiastic.  The Steering Committee has also accepted an intention to bid from Turkey, the Netherlands and Portugal.  Stiff competition we expect but we have a strong case and a destination with irresistible appeal so remain confident.  Chris Hugo-Hamman and Prof Bongani Mayosi make a further and final presentation at the next meeting of the Steering Committee in Chicago in March 2008. 

The Bid Committee (Susan Vosloo, John Lawrenson, Bongani Mayosi and Chris Hugo-Hamman) has financed the bid through generous sponsorship received from, SA Heart, Pick n Pay, Media24, Mediclinic, Netcare and Mrs Caro Wiese.  PCSSA gratefully acknowledges this support.

The Annual Congress of SA Heart in 2008 will be organised jointly by the Western Cape region of SA Heart and the PCSSA.  This will be held at the Wild Coast Sun. The PCSSA will be represented on the organizing committee by Liesl Zulke and Rik de Decker who will also coordinate our scientific programme at the Netcare symposium. 

There are difficult issues regarding our relationship with SA Heart and these will be discussed at the forthcoming AGM of the society on Saturday 24 November 2007.

I thank my colleagues on the Executive of the PCSSA for their hard work and support throughout the year.

Dr Christopher Hugo-Hamman, President

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South African Society of Cardiovascular Intervention (SASCI)

The past few years have seen the SASCI Executive full fill its mandate to establish a viable independent Working Group within SA Heart Association attending to the many needs of the community of interventional cardiology in South Africa.

In some ways, by default, SASCI has been a major provider of continued medical education for practitioners of interventional cardiology in South Africa and I think achieved a lot in that field.  This is borne out in the number of educational activities that SASCI has been involved in and discussed below in the report. We will certainly continue to provide opportunities for educational updates in its various forms to interested practitioners and urge members to avail themselves of the opportunities that are presented for them to keep up with current thoughts and techniques and provide treatment to their patients rationally.

The Executive Committee elected to a 2-year term of office ending in 2007 is -
Chairman Dr Tom Mabin  , Secretary Dr Farrel Hellig, Treasurer Dr Clive Corbett, Members - Dr Graham Cassel, Dr Jai Patel, Dr Steve Spilkin, Dr Adie Horak, Dr Mpiko Ntskhe, Mr Craig Goodburn (Industry), Me Glenda Weidemann (Industry), Executive Officer Mr George Nel

During the year SASCI have been proactive in all areas of interest. George Nel, Executive Officer, has continued in assisting us in promoting our activities during the past year.

A large part of the executive activities this year has been our joint responsibility for organising the Heart 2 Heart Congress 2007 in Sun City (22-25 November).  We plan to present robust debate between our surgical colleagues and ourselves on aspects of cardiovascular intervention with strong representation from the heart failure, paediatric cardiology and electrophysiology group. An impressive international faculty has been invited to the congress, which is being held jointly with the 4th Indian Ocean Meeting.  

Our aim to promote educational opportunities for our members have seen the following

• The exchange programme between SA and UK for interventional cardiology fellows has continued in 2007 (Boston Scientific).
  
  
• SASCI continued to actively contribute and participate in two important local training institutions. The Crossroads Institute (Baroque Medical) and Carotid Artery Stenting Education System (CASES, Cordis Johnson & Johnson) - These programs allow local interventionalists the opportunity to expand and enhance their skill, through internationally developed material, virtual reality and hands-on proctorship.
  
  
• Netcare Unitas Hospital in Pretoria hosted the 3rd Annual SASCI Fellows Workshop on 24th of February 2007. 32 delegates attended the full-day workshop, including 18 Fellows from across South Africa. This event brought together an expert interventional panel as operators and moderators with learning taking place through observation (live cases) with two-way interaction (Q and A) as well as lectures on topical subjects (“drug eluting stents and Plavix”, “IVUS – Clinical use” and “ACS – Role of LMWH”). Prof Cobus van Marle (surgeon, carotid stenting vs. surgery) and Prof Pieter Fourie (interventional radiology, contrast) shared their knowledge and tips-and-tricks as guest lecturers. Learning during the two live cases (radial approach and bifurcation lesion) was augmented by tips-and-tricks presentations by the operators from the cath lab.
  
  
• SASCI as an affiliate of EuroPCR participated in a full educational session during the Barcelona Meeting of 23 May 2007.  We had a successful collaborative session with colleagues from the Irish Cardiac Society.  Participants and audience alike enjoyed an excellent standard of talks.  We will continue participation in EuroPCR in the future. 
  
  
• SASCI participates in the Endovascular Working Group (EWG) with the Vascular Surgical Society and the Interventional Radiology Society and participated in the ASSA-SAGES Congress (Sun City 8-12 August 2007) offering a collaborative meeting between the disciplines with International speakers supported by an expert local faculty. 
  
• In partnership with Cordis J&J, SASCI helped host a live TV session from the American College of Cardiology Annual Congress, direct from New Orleans on 25 March 2007 to a number of venues in South Africa. We hope this historic initiative will be the first of many opportunities for colleagues and allied professionals worldwide to enjoy the benefits in the advances in communication and bring further education opportunities to our members.

Industry Representation has assured a close liaison between us and we continue to actively pursue collaboration on issues of common interest. These include facilitation of education resources, advice on device applications, guidelines, liaison with hospital groups etc. We remain very grateful to the industry for the financial support received.

We believe the survival of a strong Working Group in interventional cardiology is in the best interest of all players in the field, physicians, industry vendors, health funders, hospital groups and patients. For this reason, we appeal to all to support SASCI and use us to fulfil all our objectives.

We aim to continue to develop our areas of influence and offer a HELPLINE through our Executive Officer George Nel, whereby any party can access us with enquiries, requests for assistance, lobbying etc. His direct line is 083-458-5954. These requests will be dealt with in a professional and efficient manner to provide a vital service to all.

Tom Mabin

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Heart Failure Society of South Africa (HeFSSA)

The past year has seen the inaugural HeFSSA Executive full fill its mandate to establish a viable independent Special Interest Group within SA Heart Association attending to the many needs of the community of medical practitioners with an interest in Heart Failure in South Africa (and Africa).

The Executive Committee elected to a 2-year term of office ending in 2008 is -
Chairman Prof Karen Sliwa, Secretary Dr Eric Klug, Treasurer Dr Olaf Forster, Members - Dr K O’Connell, Dr M Mpe, Dr S Middlemost, Prof J Brink, Prof J Moolman, Industry Mr W Stranix, Mr R Moult, Executive Officer Mr George Nel.

Our aim to promote educational opportunities for our members have seen the following during 2007

• A Fellows Workshop, the 2007 workshop focussed on echocardiography, specifically the methods used for assessing and managing patients with heart failure. Ten Fellows currently in training attended the workshop with Dr’s Shirley Middlemost and Darryl Smith as lecturers. This workshop will be an annual event.

• From 12-16 May 2007, PASCAR together with the Kenyan Cardiac Society and HeFSSA had a very successful congress in Nairobi, Kenya. HeFSSA played a very important organizational and academic role in the planning of, conducting and presentation at the congress. Karen Sliwa and Eric Klug besides chairing sessions, organized the poster sessions, also presented on ‘The Burden of Heart Failure in Soweto” and “Inotropes in Heart Failure” respectively. Vinesh Vaghela, a member of HeFSSA presented on “Beta-blocker treatment in Africa” and another member of our society, Kemi Tibazarwa, spoke on “Heart awareness Day in Soweto”. A lunchtime meeting held jointly between HeFSSA and the WHFS (World Heart Failure Society) was well attended and both Karen Sliwa and Pim Remme (President of WHFS) presented information on their respective societies.

• As a SIG HeFSSA has been an active member of the Heart 2 Heart Congress 2007 Steering Committee (SA Heart Annual Congress at Sun City) and has substantially contributed to content and program-design to ensure that this congress will live-up to delegate expectation. A concerted effort was made to ensure that basic science and academia is accommodated in such a way that all participants share in the opportunity. The SA Heart Journal congress edition has been prepared with Prof Sliwa as editor.

• HeFSSA Executive (specifically Dr’s Olaf Forster, Eric Klug and Martin Mpe) has been contributing towards furthering academia through grading of Abstracts submitted for both PASCAR and SA Heart Congress.

• The important Heart of Soweto Registry (under the guidance of Prof Sliwa) has collected data on 4602 consecutive patients attending the Baragwanath Hospital Cardiac Clinic between January and December 2006. 52% of patients presented with heart failure, underlining the importance of this syndrome and hence the ongoing efforts to create a vital, useful Heart Failure Society (in South Africa but also an African network).

• The HeFSSA website www.hefssa.org is updated regularly and is a reference point for our members and those interested on Heart Failure. Of specific interest is THE new section “Life with Chronic Heart Failure” – During the year we introduced Pilates for the chronic heart failure patient as an important step in re-conditioning the heart failure patient.  Subsequent lifestyle issues to be included in this exciting new feature will be dietary and psychological advice for patients coping with a debilitating chronic condition. We hope to promote a holistic approach in dealing with the HF patient and to equip the patient with knowledge and contribute positively to managing the disease.

Industry Representation has assured a close liaison facilitated by George Nel. We continue to pursue collaboration on issues of common interest, which include facilitation of educational resources expenditure, advice on applications, guidelines, etc. We remain very grateful to the industry for the financial and strategic support received.

We believe the survival of a strong Special Interest Group in heart failure is in the best interest of all stakeholders (physicians, industry vendors, health funders, hospital groups, government) and especially patients. For this reason, we appeal to all to get involved in HeFSSA and contribute towards achieving our objectives.

We aim to continue to develop our areas of influence and offer a HELPLINE through our Executive Officer George Nel, whereby any party can access us with enquiries, requests for assistance, lobbying etc. His direct line is 083-458-5954. These requests will be dealt with in a professional and efficient manner to provide a vital service to all.

Karen Sliwa-Hähnle

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South African Cardiac Surgical Group

During the past two years the Society has been active in pursuing its original goals of establishing a national database, to organise and host a biennial academic meeting, to establish a curriculum and to look after the interests of its members.

The curriculum has been established and accepted by the College of Medicine. There are ongoing discussions between the College and Academic Heads regarding same.

I am delighted to report that the national database is now complete and rolled out and ready for implementation. We are indebted to Francis Smit for the enormous effort invested in this project. We are thankful for the commitment from SA Heart to fund the installation and maintenance of this very important facility. It is now up to the members of this Society to implement and make use of this database in their respective units. Needless to say, this data, once available will be all important not only to surgeons but also to our colleagues in Cardiology and will certainly help to identify and apply best clinical practice. Data derived from the database will also be invaluable to the industry as well as the Health Funder industry. No doubt this data will be sought after and the Society will play an important and pivotal role in the protection of this source of information.

This year will be the first time that the biennial meeting will be held in conjunction with the SA Heart meeting.  This has been done to ease the burden on the involved parties and the clear objective was to have fewer but more meaningful meetings. To this end the organisers have been insistent on getting representation of surgical and cardiological topics in the same plenary sessions in order to benefit both disciplines The Thoracic symposium has been included by non-negotiable necessity. The success of this meeting will determine which direction the surgeons of this country will follow in future. In recent years there has been a mushrooming of meetings, which on many occasions have taken on an entertaining rather that informative nature in which the influence of those with vested interest is often evident.

The withdrawal of SOCTS from SA Heart has been uncomfortable, but unavoidable due to the incompatibility of the respective constitutions. The surgical members of SA Heart have now been herded together in a special interest group named the South African Cardiac Surgical Group and are represented by the exco of SOCTS. This is the only way we can remain within the umbrella of SA Heart and although others and I have been apposed to such arrangement, consultative negotiation based on majority rule has resulted in the formation of this SIG.

The Society website is established and is linked to the CTS Net site which strengthens our international connection. We have adopted the Journal of Cardiac Surgery as our international academic forum and our members will in future receive a copy of the Journal included in their membership fees.

There has been continuing requests from various organizations for guidelines on competence in performing certain procedures. This, often bizarre, request is usually a blanket, bland, all encompassing one which includes all procedures performed by surgeons. This is obviously a fabrication of the ever-encroaching Funder industry, which no doubt is faced with challenges of a different nature. In surgery guidelines are included in the standard textbooks of Surgery. The reason for this sudden flurry of requests, which the Society has dealt within a rather non committal way, is no doubt due to the overlapping of invasive procedures by other disciplines into the surgical domain to which the marketing of innovative technology has contributed. Unfortunately pecuniary interest is often the driving force behind this intrusion.

There can be little doubt that Cardiac surgery will change in future, with the introduction of Endovascular technology and to enable surgeons to be adequately equipped for this, an Endovascular workshop has been arranged which will take place early in the new year.

A major challenge for the Society will be to deal with the Health Funder industry. It has been made clear by the major Funders of the health care industry that future negotiation will only be with professional Societies and the Executive has been in negotiation with only one, the biggest of these Funders, and have had preliminary talks with them, an exercise which has waxed and waned between cautious excitement and simple dissolution. Future successes will depend on strong willed negotiation and bargaining.

There has been an upsurge in litigation and this trend will no doubt continue and gain momentum. No doubt the Society will play an important role in protecting the rights of its members and I predict that this will become a major function of the Society.

All that remains is to thank the Members of the Executive for their unselfish effort and input and on behalf of the Executive we wish all members well over the festive season and a prosperous new year.

Robert Kleinloog

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