Dr.C.P.Srivatsava, Secretary IACTS, Dr.James Thomas, Senior Vice President, Dr.Sampath Kumar, Chairman CTCOM CON 2010, Members of the Executive Committee, Recipients of the Lifetime Achievement Award for this year Dr.M.R.Girinath, Dr.K.M.Cherian, Dr.Dev Saxena, Past Presidents, Members of IACTS, ladies and gentlemen.

It is an extremely proud and happy day today for me as I stand before you to deliver the Presidential Address of our Association at New Delhi during this combined conference of Indian Association of Cardiovascular Thoracic Surgeons and Asian Society for Cardiovascular and Thoracic Surgery.

I first of all thank my Lord and Saviour Jesus Christ for life, health and happiness. I specially acknowledge my wife Cheruba for being a wonderful companion for me for the past 32 years. She has stood by me and encouraged me during all my up’s and down’s. I am thankful to God for my two children Rajiv and Kalpana and their spouses Sandhya and Varun. They got married last year and in a couple of months I am going to be a proud grandfather twice over.

This year is further more satisfying since my son Rajiv has completed his MCh and has become a member of IACTS. He helped me conduct the CT CME Thoracic Surgery at TTDC Beach Resort at Mahabalipuram which by God’s grace was a great success. He has now joined me in my Thoracic Surgical practice.

I joined the Madras Medical College in 1964 as an undergraduate student and thereafter I spent 41 years till 2005 when I retired as Professor and HOD of the Cardio-Thoracic Surgery. My stint in Government Hospital gave me an opportunity to help the sick who are poor. I thoroughly enjoyed my stay there as I was very much interested in Medical Students cultural activities. Both my brother, my Father and Grandfather studied in MMC.I am grateful to my parents Dr.Mathuram Santosham and Suseela Santosham for encouraging me during my formative years. My late father started the Lung Clinic in 1937 , Santoshapuram TB Sanatorium in 1947 the year I was born and Santosham Chest Hospital in 1976. He was a Chest Physician, Thoracic Surgeon, Radiologist which he has handed over to his three son’s. My Brother Dr.Ravi.T.Santosham (Chest Physician) and Dr.Roy Santosham ( Thoracic invasive Radiologist), we have been able to work together comfortably because our wife’s have been able to get along very well with each other. My closest friend Dr.C.S.Vijayshankar & I have been classmates from school to MCh (CTS) and worked together in MMC for many years and now in Apollo Hospital, Chennai. His late father Dr.C.S.Sadasivan the first Thoracic Surgeon from MMC was also an inspiration for me to take up Thoracic Surgery, but he passed away in 1970 when he was only 54, six months before I joined the department as a Resident Intern. He pioneered Cardio-Thoracic Surgery in Government General Hospital in Chennai. I was exposed to Thoracic Surgery from my early childhood as my father who was specialized in the treatment of TB from late 30’s taught me how to do thoracoplasty under local anesthesia. My dad became a Member of Parliament and handed over his practice to me which now I share with my brother’s and my son. Right from my MCh days I took keen interest in Thoracic Surgery. It is a very active speciality in Europe and North America and is gaining popularity in India.

I am grateful to my teachers Dr.M.M.Cooper (Anatomy Professor), Dr.S.Sundar Raman my General Surgery Professor and Dr.Gowrishankar, Dr.Vasudevan, Dr.Solomon Victor, Dr.Andappan and Dr.Panchamoorthy for their guidance. Dr.R.K.Sasankh joined me in my practice as a house surgeon and has become a Professor of Cardio-thoracic Surgery in MMC. He is one of my very close Associate. I thank the Association for starting the CT CME in Thoracic Surgery and Dr.C.P.Srivatsava and Dr.Karan Singh Yadav for the G.C.Sharma fellowship in General Thoracic Surgery for training young Thoracic Surgeons. I feel it is time to have a Thoracic Surgery section in our Association like EACTS and ESTS in Europe and AATS and STS in America. We are working towards it this year.

In most Cardio-Thoracic Surgical centres in our Country very little Thoracic Surgery is being done. There are various reasons why General Thoracic Surgery is not flourishing in our country. The main reasons being

• It is not wise to do open heart surgery and lung surgery in the same theatre because of infection. To have an exclusive Thoracic Surgery theatre we must have enough load.
• Training in Thoracic Surgery needs an adequate Surgical load of at least 5 cases a week and very few centres have this.
• You need a teacher with adequate experience in General Thoracic Surgery to guide a trainee.
• A good thoracic surgeon must know which cases can be managed medically and when you will need surgery. There is a lot of fame and money in coronary surgery which attracts youngsters to it all over country. Bronchoscopy which was earlier under the domain of Thoracic Surgeon with the advent of fibre-optic bronchoscopy has been taken over by the Pulmonologists. A Thoracic Surgeon must know both rigid and fibreoptic, and also adult and paediatric Bronchoscopy as they are useful in the pre-operative, per-operative and post-operative assesment. Thoracic Surgery is technically demanding procedure with no bypass support and if you are not careful pre-operative bleeding can be fatal. There is a general feeling among youngsters that there is no money in Thoracic Surgery. This is not true. Thoracic Surgical excellence needs intense interest, hardwork and surgical skill which has to be developed. VATS and Robotic Surgery are the future of Thoracic Surgery. Youngsters in their General Surgery training are being exposed to laproscopy and can use and coordinate both hands well because their dexterity in playing video games. They must be encouraged. The limitations of VATS in our country is due to severe inflammatory lung adhesions and late diagnosis of bronchogenic carcinoma.

Lung transplantation is another challenging field which has not taken off in our country. Among the organ transplants lung transplantation has the worse pronosis because, the transplanted bronchus is in direct communication with the atmosphere and prone for infection and rejection. When I joined the MCh Cardiothoracic Surgery, it was a very popular Speciality. Of late many DNB and MCh (Cardiothoracic) are not being filled. The same thing is happening in Europe and North America. One way to make youngsters join is by starting a 6 year MCh and DNB course. The Association is having discussions with MCI and DNB regarding this.

I thank Dr.Girinath (Head of Department of CT Surgery) at Apollo Hospital for giving me long lease of life by doing CABG with a single mammary graft to LAD in 1994 which has helped me to lead an active and fruitful Surgical life..I developed an interest in Tracheal Surgery because of Prof.K.K.Ramalingam ENT Surgeon who sent me the first case. I had the privilege of meeting Dr.Hermes Grillo – Father of Tracheal Surgery at the world Congress at Hiroshima and later spent a day in his unit in Boston. Just before his death I met him in Toronto AATS meeting where he released a book and gave me an autographed copy. As Secretary IACTS and Examiner in MCh and DNB and Inspector for MCI and DNB, I have developed close friendship with my colleagues all over the Country. I specially remember Dr.Nitu Mandke and Dr.Nithyanand Shelly who are no longer with us. I thank Dr.Khandeparkar who was our Treasurer and Dr.SampathKumar, Editor for excellent support and co-operation.I was Organising Secretary of CTCON 2001 and thank my friend Dr.Prasad Rao from whom I took over as Secretary of IACTS (2004-2007).He had helped a great deal to run the Association as Secretary.

I would like to quote a passage from Bible
Blessed are all who fear the LORD,
who walk in his ways.
You will eat the fruit of your labor;
blessings and prosperity will be yours.

I strongly feel that success is a combination of Surgical and Academic opportunities and happy family life, which God has provided me in abundance. I thank everyone present in this room and the members of IACTS for their support and encouragement during my years as Secretary and President. I am proud and happy to be an Indian and I am amazed by the development in Cardio-Thoracic Surgery during my lifetime.          Jai Hind.