Introduction ERCATHAN

  logo Ercathan 3

“Hos igitur quasi vestigiis odorati tradendae medicinae initium ab humano corpore ducemus, quod et artis subjectum existit, et omnium primum sensibus occurrit notissimum: a quo dein per minima quaeque deducti ad ea denique mentis impulsu feremur, quae cogitatione sola comprehendi possunt”


“We shall start the beginning of the teaching of medicine from the human body, which is both the subject of the art of medicine and, first of all, it comes most clearly under our senses. Then from there, led through all the minutiae, we shall be finally carried by an impulse of the mind, to those things which can be understood by thinking alone.” Jean Fernel (1497–1558), physician to King Henri II of France

Chair: Y.J. Taverne MD MSc


Contact:
- For course specific questions: taverneyannick@gmail.com / y.j.h.j.taverne@erasmusmc.nl

- For course logistics: skillslab@erasmusmc.nl

Introduction
Ever since the first cadaveric dissections by the Greek physicians Herophilus of Chalcedon and Erasistratus of Chios in the early part of the third century BC, the cardiovascular system has always been a topic of fascination. Many anatomical studies have been performed; however, it took until the 16th century to describe its ‘modus operandi’. The work of William Harvey, presented in his “de Motu Cordis”, initiated this new field of interest. Despite ongoing research on physiological principles, anatomy and physiology have never been fully integrated when describing morphology.


Up until now, many see anatomy as the field of examining “that what is dead” and physiology as the study of “living things”, thereby missing a whole field of study and possibly misinterpreting or falsely deducing results. Cardiac formation and each morphological adaptation is based on physiological principles, explained by the laws of physics, and derived from an evolutionary origin. One must keep in mind that our ‘human’ heart has been formed by a process over millions of years which resulted in the current shape, position and functionality.


As stated, there is still a discrepancy to implement functionality when examining the morphology of the heart. The relationship between form (anatomy) and functionality (physiology) has never been more pertinent than today. New surgical and interventional techniques dictate a refined anatomical analysis from a functional point of view.


Therefore, this cardiothoracic forum (ERCATHAN) was created, trying to give an answer to the many questions consequent to new technologies. The research and different masterclasses within ERCATHAN focus on these questions and try to explain functionality, and thus morphology, from a multitude of approaches, including evolutionary, comparative and functional anatomy.

Masterclasses


Functional and Applied Cardiac Morphology: ’from evolution to clinic’.
Level: Advanced
Audience: Cardiology residents, cardiologists, echocardiographers, cardiac researchers.
Course: 1 day national masterclass.
Accreditation + certificate via the CVOI (CardioVasculair Onderwijs Instituut).
Language: Dutch
Date: Several dates per year. See website ERCATHAN for the next course date.
Faculty: Y.J. Taverne MD MSc, D.J. Duncker MD PhD

Cardiac Functional Anatomy in Health and Disease.
Level: Basic
Audience: Paramedics, cardiac researchers, junior cardiologists in training.
Course: 1 day national masterclass.
accreditation + certificate.
Language: Dutch
Date: Several dates per year. See website ERCATHAN for the next course date.
Faculty: Y.J. Taverne MD MSc

Functional Anatomy of the Pulmonary System for Minimal Invasive Surgery.
Level: Advanced
Audience: Residents cardiothoracic surgery, residents general surgery with pulmonary surgical differentiation, general surgeons.
Course: 2 day international masterclass.
accreditation + certificate.
Language: Dutch / English
Date: Annual. See website ERCATHAN for the next course date.
Faculty: Y.J. Taverne MD MSc, L. Maat MD, O. Birim MD PhD, J. Siebenga MD PhD

Functional Anatomy of the Cardiac Valves for Minimal Invasive Surgery.
Level: Advanced
Audience: Residents cardiothoracic surgery, cardiothoracic surgeons.
Course: 2 day international masterclass (part of a 5 day course from the European Association for CardioThoracic Surgery - EACTS)
accreditation + certificate via the EACTS.
Language: English
Date: Annual. See website ERCATHAN for the next course date.
Faculty: Y.J. Taverne MD MSc, A.P. Kappetein MD PhD, P. Sardari Nia MD PhD

Functional Cardiac Anatomy and Hemodynamics for Invasive Monitoring.
Level: Advanced
Audience: Cardiology residents.
Course: part of a 1 day masterclass on invasive hemodynamic monitoring and simulation training via the CVOI (CardioVasculair Onderwijs Instituut).
Accreditation + certificate via the CVOI.
Language: Dutch
Date: Several dates per year. See website CVOI for the next course date.
Faculty: Y.J. Taverne MD MSc, L. Jewbali, MD

Research


Throughout past years, many new interventions and techniques have been developed. By approaching the heart form another point of view, new questions raise concerning cardiac morphology. As already stated, anatomical understanding of the heart moved from a topographic approach to a functional one where the laws of physics are used to explain the impact of physiology on its morphological derivative. In order to explain functionality and properly describe morphology, the heart cannot be seen as a sole anatomical unit but, rather, has to be described as a functional entity designed for creating optimal hemodynamics. If we want to fully comprehend its ‘modus opperandi’, it is necessary to study different aspects of cardiac organogenesis thereby implementing embryology and comparative, evolutionary and functional anatomy.


Besides the use of basic sciences to describe the heart, different cardiac medical specialties need to be connected as each specialty looks at the heart from a different point of view. The risk of being highly specialized in each field, is that the overall picture is fading. Therefore, a ‘think tank’ was created within ERCATHAN providing an environment where specialists of different fields of cardiology can post a clinical issue that needs to be studied and where the problem at hand can be discussed by a multitude of cardiac specialists.

Current research topics
1. Micro-architecture atria in relation to Bachmann’s bundle and the septum secundum
2. Morphological substrate for atrial fibrillation
3. Functional anatomy and biomechanics of the mitral valve: possible pitfalls for trans-catheter mitral valve replacement
4. Functional anatomy and fluid dynamics of the aortic root.