Case definition (for logbooks)

2nd November 2015

The SAC in Cardiothoracic Surgery has done a thorough piece of work clarifying the definition of a ‘case’ for the purpose of trainees and trainers recording it as such.

Mr Joel Dunning and Ms Clare Burdett have collated all the opinions of the definitions (for Lobectomy, CABG and AVR) and then refined those opinions to a consensus view using a ‘Delphi Process.’ These definitions have now been sent to all trainees and training programme directors in the letter attached below.

All trainers and trainees are now requested to use these definitions for logbooks and CCT applications.

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Please find below the definitions of a ‘case’ for the most commonly performed procedures. These definitions should be applied when completing logbook entries and for CCT. They will also apply to the Matrix for entry into the Specialty.

We hope you find them useful – they have been specifically introduced to help guide you and make the recording of cases fair and accountable for all trainees. The definitions have been chosen after consultation with both trainees and trainers (through a Delphi Process) to ensure they are workable and based on consensus.

Coronary Artery Bypass Grafting:
Majority of Bottom & Majority of Top Ends

Aortic Valve Replacement:
Aortotomy + Valve Excision + Suture in Valve & Tie Down + Aortotomy Closure

Lobectomy:
Majority of Vessels & Bronchus + Hilar Dissection

If you perform less than the above definition, please record the individual parts that you performed (i.e. top end) but do not record it as a case.

As you can see, definitions for all 3 procedures focus on the ‘central part of the operation’. Please use the same philosophy when recording other procedures not defined here.
For more complex operations such as AVR & CABG, if you complete only one of the two, you can record it as such (e.g. AVR Case if you do the AVR part only).

For an Independent Case, the definition is:

Consultant not scrubbed entire case – but can be in theatre

You should use these definitions from the date of this publication. Modifying previous logbook entries is at your own discretion.

Simon Kendall
Hon Sec SCTS