Cardiothoracic Oral Board Practice Cases by ABTS Domain
A public-blueprint-aligned practice map for original educational scenarios—organized to prevent the stronger half of cardiothoracic surgery from hiding the weaker half.
Key takeaways
- Mirror the official 6-and-6 split when building practice volume.
- Every topic should include patient selection, operative judgment, postoperative care, and at least one complication branch over time.
- Malignant lung, malignant esophageal, ischemic, valvular, and aortic topics have explicit published scenario counts.
- Use mixed rooms to test cognitive switching rather than studying cardiac and thoracic in permanent silos.
- Practice prompts should be original and must not reproduce secure ABTS content.
Official distribution
Start with the 12-scenario public matrix
| Side | Published count | Core distribution |
|---|---|---|
| Cardiac | 6 | Two ischemic; two valvular including transcatheter; one aortic root/ascending/arch; one additional scenario from MCS, adult congenital, rhythm, or another listed breadth area. |
| General thoracic | 6 | Two malignant lung; one malignant esophageal; one benign esophageal; two additional scenarios distributed among benign lung, pleural, mediastinal, and chest-wall disease. |
Six cardiac protocols
Cardiac practice library
Ischemic: stable multivessel disease with competing strategies
Define candidacy, anatomy, conduit plan, completeness, perioperative risk, operation, graft verification, and postoperative ischemia rescue.
Ischemic: acute or failed revascularization
Prioritize shock, ischemia, mechanical complications, cath versus operating-room pathway, mechanical support, and bailout.
Valvular: repair versus replacement
Explain mechanism, timing, repairability, prosthesis implications, associated disease, intraoperative imaging, residual lesion, and reintervention.
Valvular: open versus transcatheter strategy
Integrate anatomy, surgical risk, durability, coronary access, concomitant disease, patient values, and rescue of access or device complications.
Aortic: root, ascending, or arch disease
Define extent, urgency, cannulation, cerebral and organ protection, reconstruction, malperfusion, bleeding, and neurologic rescue.
Additional breadth: MCS, adult congenital, or rhythm
Practice candidacy, anatomy, timing, multidisciplinary planning, technical strategy, failure modes, and long-term management.
Six general thoracic protocols
General thoracic practice library
Malignant lung: early-stage resectable disease
Complete diagnosis and stage, physiologic assessment, extent of resection, nodal strategy, minimally invasive versus open approach, margins, and postoperative air leak.
Malignant lung: locally advanced or medically complex disease
Integrate invasive staging, induction or definitive therapy, resectability, sleeve or extended resection, risk, and salvage strategy.
Malignant esophageal disease
Stage, choose treatment sequence, assess candidacy, describe esophagectomy and conduit, then rescue leak, ischemia, airway injury, or chyle leak.
Benign esophageal disease
Differentiate motility, reflux, diverticular, perforation, and reoperative problems; select repair or resection and protect function.
Pleural, benign lung, or infection
Establish source control, lung expandability, drainage or decortication strategy, airway issues, fistula, and postoperative sepsis rescue.
Mediastinal or chest-wall disease
Define diagnosis, invasion, need for tissue, resectability, multidisciplinary reconstruction, margin, nerve or vascular risk, and recurrence planning.
Four layers per topic
Build each domain beyond the ideal operation
| Layer | What the prompt should test |
|---|---|
| Selection and diagnosis | Urgency, differential, stage, physiology, candidacy, goals, and missing information. |
| Preparation and operation | Optimization, team and resources, exposure, protection, technical sequence, verification, and bailout. |
| Early postoperative course | Expected physiology, monitoring, ventilation, hemodynamics, analgesia, drainage, rhythm, nutrition, and prevention. |
| Complication and recovery | Recognition, stabilization, diagnosis, definitive rescue, communication, reoperation threshold, and follow-up. |
Third-room rehearsal
Construct a realistic mixed room
- 01
Cardiac protocol one
Use a common matrix topic but begin with incomplete information to test prioritization.
- 02
Thoracic protocol one
Switch immediately to stage or resectability language and avoid carrying cardiac assumptions forward.
- 03
Cardiac protocol two
Use a complication-heavy scenario that requires an explicit support or reoperation threshold.
- 04
Thoracic protocol two
Close with airway, leak, sepsis, or oncologic rescue to test stamina and domain reset.
- Four protocols fit within 30 minutes without teaching between cases.
- Two cardiac and two thoracic scenarios are represented.
- At least one case requires an operation description.
- At least one case changes into an unstable-patient branch.
- The examiner interrupts and transitions neutrally.
- Feedback is withheld until the room ends.
Coverage discipline
Track more than a total case count
- Cardiac versus general thoracic protocol count.
- Topic distribution against the public matrix.
- Elective, urgent, and emergent presentations.
- Open, minimally invasive, transcatheter, endovascular, and nonoperative decisions where appropriate.
- Operation-description opportunities.
- Early and late complication branches.
- Cases requiring explicit palliation or nonbeneficial-care boundaries.
- Mixed-room transitions and performance after a difficult prior case.
- Unresolved behavior patterns, not just unanswered facts.
Put the framework under pressure
Practice the answer out loud—not only on paper.
Voice-first cases, adaptive examiner follow-up, imaging, complications, and structured educational feedback for cardiothoracic surgery.
Questions candidates ask
Frequently asked questions
How many cardiac and thoracic practice cases should I do?
Use an approximately equal split and ensure coverage of every public matrix category. The exact total should be driven by repair quality and stable performance across multiple cases, not a universal quota.
Should every case include a complication?
Not every individual case must deteriorate, but complication management should appear frequently because the public matrix allows postoperative care and complication questions in every protocol.
Are these official ABTS cases?
No. They are original educational case concepts organized by the public matrix. Secure ABTS protocols are not reproduced or solicited.
Source transparency
Official references
Board requirements, dates, and candidate instructions can change. Confirm current details directly with ABTS and the Board’s candidate portal.
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