George Tolis: TAVR, Broken Training, and What's Really Wrong With Cardiac Surgery.

About this episode

Dr. George Tolis discusses the state of cardiac surgery, the implications of TAVR, and the challenges in surgical training.

Episode Summary Dr. George Tolis, section chief of coronary and general cardiac surgery at Brigham and Women's Hospital, joins Drs. Koka and DiGiorgio for a wide-ranging conversation on the state of cardiac surgery. He makes the case that TAVR — while genuinely transformative for the right patient — is being systematically applied too broadly, driven by industry incentive and the erosion of meaningful surgical consent. He discusses his collaboration with John Ioannidis that found no statistically significant mortality benefit for any new cardiac surgery technique introduced over the past 35 years, the paper's rejection by every major surgical journal, and what he paid out of pocket to make it open access. The conversation moves to the collapse of surgical training — fragmented pathways, work hour restrictions that leave residents unprepared for attending life, an academic promotion system that ignores teaching, and a culture that routes incompetent trainees around rather than out — and closes with a brief on Vasily Kolesov, the Soviet surgeon from Leningrad who performed the world's first documented coronary bypass years before Favaloro, and whose work was buried by the Cold War…

People in this episode

Hosts: Koka, DiGiorgio

Guest: George Tolis

Topics covered

• cardiac surgery
• TAVR
• surgical training
• informed consent
• medical ethics
• historical surgery

Keywords

• TAVR
• cardiac surgery
• surgical training
• informed consent
• mortality benefit
• medical ethics
• historical surgery

Mentioned in this episode

Organizations: Brigham and Women's Hospital

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