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Mestres et al. Vessel Plus 2019;3:38 I http://dx.doi.org/10.20517/2574-1209.2019.20 Page 9 of 12

Figure 6. A glimpse into the future. Initial validation step of CT vs. Echo segmentation merged together in one image. TV: tricuspid valve

The key point is not to make the interpretation of information derived from clinical trials, or to learn how
to work with a modern state-of-the-art technology or simply to perform a given procedure with success.
Embracing technologies, analyzing data, acquiring hands-on proficiency in something are important in
the daily medical practice. However, the most important is the intellectual changes required to understand
a rapidly changing scenario and how to adapt to a fast-moving world that entails professional new
opportunities.

The intellect is a unique characteristic of the human being. The intellect is the faculty of reasoning and
[57]
understanding objectively, especially with regard to abstract matters . As it is supposed to be the most
advanced in comparison with the remaining of the living species, it makes sense to understand that
challenges in Cardiac Surgery do have a critical intellectual component.

THE FRONTIER
[58]
A frontier is defined as the extreme limit of understanding or achievement in a particular area .
Therefore, this definition entails a substantial intellectual component. What seems clear is that all is about
our understanding of the problem. The current scenario is that of technological evolution, combined with
changing patterns in patient and environmental complexity, the availability of techniques allowing for a
reduced access for treatment of structural heart diseases and changes in therapeutic paradigms through
the collection of evidence.

The frontier is the ability to update our knowledge and skills and to implement responses that will allow to
redesign and reorganize the surgical practice by expanding the surgical portfolio.