Heart Valve Surgery Performed by Trainee Surgeons: Meta-Analysis of Clinical Outcomes

Heart, Lung & Circulation
Akshat SaxenaPaul G Bannon

Abstract

Cardiac surgical units must balance trainee education with the duty to provide optimal patient care. This is particularly challenging with valvular surgery, given the lower volume and increased complexity of these procedures. The present meta-analysis was conducted to assess the impact of trainee operator status on clinical outcomes following valvular surgery. Medline, Embase and CENTRAL databases were systematically searched for studies reporting clinical outcomes according to the training status of the primary operator (consultant or trainee). Data were extracted and meta-analysed according to pre-defined endpoints. Eleven observational studies met the inclusion criteria, reporting on five patient cohorts undergoing mitral valve surgery (n=3975), six undergoing aortic valve replacement (AVR) (n=6236) and three undergoing combined AVR and coronary artery bypass grafting (CABG) (n=3495). Perioperative mortality was not significantly different between trainee and consultant cases for mitral valve surgery (odds ratio [OR] 0.92; 95% confidence interval [CI], 0.62-1.37), AVR (OR 0.67; 95% CI, 0.37-1.24), or combined AVR and CABG (OR 1.07; 95% CI, 0.40-2.85). The incidences of perioperative stroke, myocardial infarction, arrhythmias...Continue Reading

Citations

Aug 21, 2020·ANZ Journal of Surgery·Nicholas W JohnsonChristopher E Brooks
Feb 15, 2021·The Journal of Thoracic and Cardiovascular Surgery·John D ClevelandVaughn A Starnes
Jun 6, 2021·Seminars in Thoracic and Cardiovascular Surgery·Suvitesh LuthraSunil K Ohri
Aug 7, 2021·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Arnaldo DimagliGianni D Angelini
Aug 19, 2021·Seminars in Thoracic and Cardiovascular Surgery·Ryan ChabanAhmed Ghazy
Dec 24, 2019·The Journal of Thoracic and Cardiovascular Surgery·Elizabeth D KrebsLeora T Yarboro

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