Long-Term Results of Heart Operations Performed by Surgeons-in-Training

@article{Stoica2008LongTermRO,
  title={Long-Term Results of Heart Operations Performed by Surgeons-in-Training},
  author={Serban Stoica and Dimitri Kalavrouziotis and Billie-Jean Martin and Karen J. Buth and Gregory Marshal Hirsch and John A P Sullivan and Roger J. F. Baskett},
  journal={Circulation},
  year={2008},
  volume={118},
  pages={S1-S6}
}
Background— We investigated the association between trainees performing supervised operations and late outcomes of patients undergoing cardiac surgery. Methods and Results— Data were prospectively collected on patients who underwent coronary artery bypass graft surgery, aortic valve replacement, or a combination of these between 1998 and 2005 at the Maritime Heart Center, Halifax, Canada. In-hospital mortality and a composite outcome of in-hospital mortality, stroke, bleeding, intra-aortic… 
Excellent short- and long-term outcomes after concomitant aortic valve replacement and coronary artery bypass grafting performed by surgeons in training.
TLDR
Concomitant aortic valve replacement and coronary artery bypass grafting can be safely and effectively performed by properly supervised trainees in the contemporary era and is imperative to offer training opportunities to junior surgeons in this complex procedure to ensure quality patient outcomes in the future.
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It is possible for trainees to perform high risk cardiac surgery without compromising the quality of patient care, and NYHA class, diabetes and emergency/salvage surgery were predictors of worse composite outcome.
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TLDR
There was no difference in mortality, major morbidity, or length of stay when similar cases were compared that were operated on by attendings versus those by a resident, and multivariable logistic regression was repeated.
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TLDR
A repeated systematic review of deaths in patients with a low preoperative risk showed that a majority of deaths were preventable, and therefore potentially avoidable.
Death in low-risk cardiac surgery: Stockholm experience.
TLDR
A systematic and structured analysis of the circumstances resulting in death in low-risk patients, in addition to traditional morbidity and mortality conferences, have the potential to identify problems and offer improvements in the quality of care.
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