Trainees operating on high-risk patients without cardiopulmonary bypass: a high-risk strategy?

The Annals of Thoracic Surgery
Raimondo AscioneGianni D Angelini

Abstract

The safety of teaching off-pump coronary artery bypass grafting to trainees is best tested in high-risk patients, who are more likely to experience significant morbidity after surgery. This study compared outcomes of off-pump coronary artery bypass grafting operations performed by consultants and trainees in high-risk patients. Data for consecutive patients undergoing off-pump coronary artery bypass grafting were collected prospectively. Patients satisfying at least one of the following criteria were classified as high-risk: age older than 75 years, ejection fraction less than 0.30, myocardial infarction in the previous month, current congestive heart failure, previous cerebrovascular accident, creatinine greater than 150 micromol/L, respiratory impairment, peripheral vascular disease, previous cardiac surgery, and left main stem stenosis greater than 50%. Early morbidity, 30-day mortality, and late survival were compared. From April 1996 to December 2002, 686 high-risk patients underwent off-pump coronary artery bypass grafting revascularization. Operations by five consultants (416; 61%) and four trainees (239; 35%) were the focus of subsequent analyses. Nine visiting or research fellows performed the other 31 operations. Prog...Continue Reading

References

Oct 1, 1995·The Journal of Thoracic and Cardiovascular Surgery·Y MoshkovitzR Mohr
Mar 1, 1995·British Heart Journal·S Westaby
Jul 1, 1999·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·R AscioneG D Angelini
Sep 4, 1999·The Annals of Thoracic Surgery·R AscioneG D Angelini
Oct 30, 1999·The Annals of Thoracic Surgery·J BergslandT A Salerno
Feb 2, 2000·The Annals of Thoracic Surgery·H L KaramanoukianT A Salerno
Apr 6, 2000·The Annals of Thoracic Surgery·K V AromR J Petersen
Sep 2, 2000·The Annals of Thoracic Surgery·M RicciT A Salerno
Feb 13, 2001·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·M P WattersG D Angelini
Apr 20, 2001·The Annals of Thoracic Surgery·M CaputoG D Angelini
May 8, 2001·The Thoracic and Cardiovascular Surgeon·D P JenkinsE E Smith
Jun 25, 2002·The Annals of Thoracic Surgery·Martin H ChamberlainGianni D Angelini
Oct 29, 2002·The Annals of Thoracic Surgery·Roger J F BaskettJohn A Sullivan
Oct 29, 2002·The Annals of Thoracic Surgery·Massimo CaputoGianni D Angelini

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Citations

Mar 5, 2010·The New England Journal of Medicine·John D PuskasCraig R Smith
Oct 30, 2012·Heart, Lung & Circulation·J J B EdelmanM P Vallely
Jun 16, 2012·The Annals of Thoracic Surgery·Faisal G BakaeenWilliam L Holman
Jul 5, 2011·The Journal of Thoracic and Cardiovascular Surgery·Irving L Kron
Oct 19, 2010·The Journal of Thoracic and Cardiovascular Surgery·Nishith N Patel, Gianni D Angelini
Mar 28, 2009·The Annals of Thoracic Surgery·Faisal G BakaeenJoseph Huh
Mar 12, 2016·Journal of Surgical Education·Nigel D'SouzaRajesh Aggarwal
Jun 6, 2006·Revista española de cardiología·José M González Santos
Oct 17, 2015·The Journal of Thoracic and Cardiovascular Surgery·G Hossein AlmassiUNKNOWN Veterans Affairs #517 Randomized On/Off Bypass (ROOBY) Study Group
Jun 19, 2010·ANZ Journal of Surgery·Diana Tam, Jonathan Wheeler
Dec 2, 2004·The Journal of Thoracic and Cardiovascular Surgery·Massimo CaputoGianni D Angelini
Jun 25, 2005·The Annals of Thoracic Surgery·Christos AlexiouTomasz J Spyt
Oct 26, 2005·The Annals of Thoracic Surgery·Gavin J MurphyGianni D Angelini
Nov 5, 2011·The Journal of Thoracic and Cardiovascular Surgery·Michele MurziGianni D Angelini
Nov 28, 2009·Seminars in Thoracic and Cardiovascular Surgery·Michael E Halkos, John D Puskas
Jan 24, 2006·The Annals of Thoracic Surgery·George AsimakopoulosVenkatachalan Chandrasekaran
Oct 21, 2006·Current Opinion in Cardiology·Joseph Noora, John D Puskas
Jul 2, 2009·The Journal of Bone and Joint Surgery. British Volume·J PalanUNKNOWN EPOS study group
Nov 21, 2017·Interactive Cardiovascular and Thoracic Surgery·Vito D BrunoHunaid A Vohra
Jun 6, 2021·Seminars in Thoracic and Cardiovascular Surgery·Suvitesh LuthraSunil K Ohri

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