Guidelines for the Establishment of an Adult Cardiac Surgery Unit (CSU)

Abstract

1 2. A Cardiac catheterisation laboratory or angiography suite on-site. 3. At least one operating theatre of adequate size, where we recommend 55 square metres (sqms) which is suitably equipped to perform Cardiac surgery. It is strongly advised that in any new CSU, at least one of the theatres is a hybrid, or has a capacity to upgrade to having both operating and angiographic facilities. We recommend a minimum area of 70 sqms for a hybrid theatre, plus an additional area up to 150 sqms in total to include the control room, etc. The theatre suite must include ew CSU [1]. The ultimate goal is to provide the highest quality of are and cardiac surgical service in the most cost-effective anner. As a general principle, a CSU should only be estabished in, or co-located with a tertiary referral hospital with stablished facilities as detailed below [1,2]. It is advised that a newly established CSU should have liaison or consulting arrangement with an established SU, one which has performed 400 plus cases per year or three or more years. This would ensure a platform for xchange of ideas, setting up protocols, quality control, elping out in case of difficulty and most importantly, in he training of personnel. These guidelines will be considered under the following an anaesthetic induction or monitoring area, proximate equipment storage, a perfusion store and separate instrument and perfusion set up areas. The theatre should be dedicated to cardiac surgery only and the theatre must have class ‘A’ air conditioning, in terms of air exchange, flow and filtration [19]. 4. There should be a separate cardiac surgical ward to manage the patient peri-operatively. This should include dedicated patient monitoring systems and telemetry. The set-up must include the capability to visually monitor all patients simultaneously, at least for the high dependency part of the ward. 5. There should be a high dependency or step-down eadings: unit. This should have facilities for invasive pressure monitoring, running defined doses of inotropes and