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Skills and Procedures Form - Cardiovascular Thoracic Surgery
Surgical Procedures
Please list the approximate number performed within the past 24 months
General
Plastic
Vascular
Arteriovenous shunt
Fem-poplitial bypass
Lower leg bypass
Ilio-femoral/iliac bypass
Endovascular aortic bypass
Other Endovascular procedure
Carotid endarterectomy
Subclavian steal procedure
Thoracic outlet procedure
Endarterectomy – renal
Endarterectomy – other peripheral
Insertion Greenfield filter
Portocaval shunt
Cardiothoracic
Coronary Artery Bypass Surgery
Valvular Surgery
Aneurysm repair
Aorta-abdominal
Aorta-thoracic
Lung resection/reconstruction
Chest wall or pleural procedures
Mediastinoscopy or exploration
Esophagus and diaphragm surgeries
Permanent cardiac pacemakers
AICD (Automatic Internal Cardiac Defibrillator)/Other Defibrillator
Cardiac transplantation
Pulmonary transplantation
Left ventricular assist devices
Specific Types:
Other Procedures
Please check your clinical capabilities, and where indicated, list the approximate number performed within the past 24 months.
Ventilation management
Chest tube insertion
Bronchoscopy
Hemodynamic evaluation and management (including devices placement)
Central line
Arterial line
Swan-Ganz insertion
Swan-Ganz monitoring
IABP (Intra Aortic Balloon Pump)
Ventilator care
Pediatrics
Other
Laser Certification
List Specific Types
Please list any limitations or comments on information provided above:
I affirm that all information provided on this page is true and accurate.
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Date
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