• J. Thorac. Cardiovasc. Surg. · Feb 2013

    Comparative Study

    Excellent short- and long-term outcomes after concomitant aortic valve replacement and coronary artery bypass grafting performed by surgeons in training.

    • Akshat Saxena, Diem Dinh, Julian A Smith, Christopher M Reid, Gilbert C Shardey, and Andrew E Newcomb.
    • Department of Cardiothoracic Surgery, St Vincent's Hospital Melbourne, Fitzroy, Victoria, Australia.
    • J. Thorac. Cardiovasc. Surg.. 2013 Feb 1;145(2):334-40.

    ObjectiveNo previous studies have specifically addressed the effect of training on outcomes after concomitant aortic valve replacement and coronary artery bypass grafting. This study evaluated the early and late outcomes after concomitant aortic valve replacement and coronary artery bypass grafting performed by surgeons in training.MethodsA retrospective analysis of data collected prospectively by the Australian and New Zealand Society of Cardiac and Thoracic Surgeons Cardiac Surgery Database between June 2001 and December 2009 was performed. Concomitant aortic valve replacement and coronary artery bypass grafting was performed in 2540 patients; of these procedures, 290 (11.4%) were by trainees. Patient demographics, intraoperative characteristics, and early morbidity were compared between trainee and staff cases using chi-square analysis and t tests. Multivariate analyses were used to determine the independent association of training status with 30-day and late mortality.ResultsCompared with staff cases, trainee cases were younger (mean age, 73.0 vs 74.2 years; P = .025) and less likely to present with triple vessel disease (27.9% vs 38.3%, P = .001) or previous cardiac surgery (6.3% vs 2.8%, P = .016). Trainee cases had longer mean perfusion (160.4 vs 144.6 minutes, P < .001) and crossclamp (125.2 vs 114.6 minutes, P < .001) times. The incidence of early complications was similar between the 2 groups. On multivariate analysis, trainee status was not associated with an increased risk of 30-day mortality (2.4% vs 4.0%, P = .348). Moreover, there was no significant difference in long-term outcomes, and 5-year survival was comparable in both groups (79.6% vs 77.4%, P = .200).ConclusionsConcomitant aortic valve replacement and coronary artery bypass grafting can be safely and effectively performed by properly supervised trainees in the contemporary era. It is imperative to offer training opportunities to junior surgeons in this complex procedure to ensure quality patient outcomes in the future.Crown Copyright © 2013. Published by Mosby, Inc. All rights reserved.

      Pubmed     Free full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…