Navigation Links
American Heart Association Journal Report: Surgical Residents Perform Heart Surgery as Effectively as Staff Surgeons

Study highlights:

* Success rates, safety and long-term outcomes of heart surgery are not significantly different when performed by properly supervised surgical residents or staff surgeons.

* It is safe to include the training of residents even in complex procedures. It is critical that trainees operate because they will to be the surgeons operating on the next generation, researchers said.

* The study was conducted between 1998-2005 at the Maritime Heart Center in Halifax, Canada.

DALLAS, Sept. 30 /PRNewswire-USNewswire/ -- Clinical success rates and safety are similar between surgical residents and staff surgeons performing heart surgery, according to a new long-term study reported in the Cardiovascular Surgery Supplement of Circulation: Journal of the American Heart Association.

In the study, surgical residents and staff surgeons performed two common heart operations -- coronary artery bypass surgery (CABG) and aortic valve replacement (AVR) -- or combined CABG and AVR. A surgical resident is a physician receiving specialized clinical training in the art and science of surgery in a hospital, usually after completing an internship.

In CABG, the surgeon reroutes, or "bypasses," blood around clogged arteries to improve blood flow and oxygen to the heart. Heart valves regulate the flow of blood inside the heart. During these types of heart operations, the patient is usually connected to a heart-lung machine that supplies blood to the brain and body. The bad valve is removed and replaced.

The study found operations performed by properly supervised residents were as safe as those performed by staff surgeons. The analysis focused on 5,703 staff surgeon-performed cases and 1,011 resident-performed cases from 1998 to 2005 involving seven staff surgeons and six residents at the Maritime Heart Center in Halifax, Canada.

"There doesn't appear to be any significant difference in the long-term outcome comparing cases performed by residents as the primary surgeon or by staff as the primary surgeon," said Roger J. F. Baskett, M.D., senior author of the study and assistant professor of surgery at Dalhousie University in Halifax, Nova Scotia, Canada.

The study examined long-term clinical outcome, as measured by death, re-admission to the hospital for acute coronary syndrome, heart failure and repeat procedures.

The findings showed that patient survival, without adverse events, was similar between heart surgery performed by residents and by staff surgeons. The resident-performed cases were not associated with late death or re-hospitalization.

The resident cases as a group were also sicker with greater co-morbidities when compared to the staff cases. Baskett said residents, who generally chose which cases they would operate on, tended to choose sicker patients and more complex cases because they felt the learning opportunities were greater.

Overall, the average age of the patients was 65 years old. About 25 percent were women. The patients also had other diseases that ranged from diabetes, high blood pressure and peripheral vascular disease to cerebrovascular disease, previous heart attack and previous atrial fibrillation. About 35 percent of the patients in both groups had diabetes. About 50 percent of the patients underwent elective surgery, while about 15 percent underwent urgent or emergency surgery. Of the procedures the majority of the patients received isolated CABG.

Resident cases: Staff cases:

CABG 79.2 percent CABG 87 percent

AVR 11.2 percent AVR 6.6 percent

Combined 9.6 percent Combined 6.4 percent

Event-free survival rates were:

-- One year after surgery -- 81.3 percent for staff cases vs. 79.1 for

resident cases.

-- Three years after surgery -- 68.2 percent for staff cases vs. 66.7

percent for resident cases.

-- Five years after surgery -- 58.6 percent for staff cases vs. 55.8

percent for resident cases.

None of these differences were statistically significant after considering that as a group the patients operated on by residents as primary surgeons were sicker.

The average follow-up time was three years, with a maximum of eight years.

Baskett emphasized the importance of supervised training of surgical residents, especially for the benefit of future generations of heart surgery patients.

"The important message is that it is safe to train residents if they are appropriately supervised," Baskett said. "It is not only safe, even with complex procedures, but it is very important. That should make patients very comfortable. It is critical that trainees operate because they're going to be the ones operating on the next generation -- your kids."

The National Center for Health Statistics estimates that in 2005, 469,000 CABG procedures were performed on 261,000 patients in the United States and there were 106,000 valve replacements.

Co-authors are: Serban C. Stoica, M.D.; Dimitri Kalavrouziotis, M.D.; Billie-Jean Martin, M.D.; Karen J. Buth, M.Sc.; Gregory Hirsch, M.D.; and John A. Sullivan, M.D. Individual author disclosures can be found on the manuscript.

Statements and conclusions of study authors published in American Heart Association scientific journals are solely those of the study authors and do not necessarily reflect the association's policy or position. The association makes no representation or guarantee as to their accuracy or reliability. The association receives funding primarily from individuals; foundations and corporations (including pharmaceutical, device manufacturers and other companies) also make donations and fund specific association programs and events. The association has strict policies to prevent these relationships from influencing the science content. Revenues from pharmaceutical and device corporations are available at

SOURCE American Heart Association
Copyright©2008 PR Newswire.
All rights reserved

Related medicine technology :

1. International Medical Corps Matched with Top 25 American Express Members Project, Saving the Lives of Malnourished Children
2. VIA Pharmaceuticals to Present at American Heart Association Scientific Sessions 2008
3. Alpharma Announces Positive Results From Pivotal Phase III Efficacy Trial on ALO-01 (EMBEDA(TM)) (morphine sulfate extended-release with sequestered naltrexone hydrochloride) Capsules at the American Academy of Pain Management Annual Clinical Meeting
4. Ardea Biosciences to Present Data on Lead MEK Inhibitor, RDEA119, at American College of Gastroenterology Annual Scientific Meeting
5. American Heart Journals Publishes Results From ERATO Trial Showing Dronedarone (Multaq(R)) Improves Ventricular Rate Control in Patients With Permanent Atrial Fibrillation
6. American Lung Association Study Finds No Evidence of Depression or Suicide Linked to Asthma and Allergy Drug Montelukast
7. Journal of the American Dental Association Publishes Key Clinical Data for the Use of OraVerse(TM) a Local Anesthetic Reversal Agent
8. Alzheimers Foundation of America Survey: Americans With Memory Concerns Fall Short of Talking to Doctors
9. Groundbreaking American Journal of Play from Strong National Museum of Play(R) Premiers July 2008
10. Genaera Corporation Presents Data on Mechanism of Inhibition of PTP-1B for Trodusquemine (MSI-1436) at Federation of American Societies for Experimental Biology (FASEB) Meeting
11. Data Presented at American Headache Societys Annual Scientific Meeting Show Primary Endpoint Met as Well as Improvement on Important Secondary Endpoints in Phase IIb Acute Migraine Trial of TorreyPines Therapeutics Tezampanel
Post Your Comments:
(Date:11/26/2015)... DUBLIN , November 26, 2015 /PRNewswire/ ... the addition of the "2016 Future ... Drugs of Abuse Testing Market: Supplier Shares, ... report to their offering. --> ... of the "2016 Future Horizons and ...
(Date:11/26/2015)... Nov. 26, 2015 Research and Markets ( ... "Advanced Wound Care Market by Type (Dressings, Therapy Devices, ... (In-Patient Facility, Out-Patient Facility), and Geography - Global Forecast ... --> --> The purpose ... and forecast of the global advanced wound care market. ...
(Date:11/26/2015)... Research and Markets ( ) ... Future Horizons and Growth Strategies in the Italian ... Segment Forecasts, Competitive Intelligence, Emerging Opportunities" report ... --> This new 247-page report ... drug monitoring market, including emerging tests, technologies, instrumentation, ...
Breaking Medicine Technology:
(Date:11/27/2015)... ... November 27, 2015 , ... The print component ... Today in Atlanta, Dallas, New York, Minneapolis, South Florida, with a circulation of ... distributed nationally, through a vast social media strategy and across a network of ...
(Date:11/27/2015)... ... November 27, 2015 , ... MPWH, the No.1 Herpes-only dating community in the world, revealed ... 1-1 ). More than 3.7 billion people under the age of 50 – or ... to WHO's first global estimates of HSV-1 infection . , "The data shocks us ...
(Date:11/27/2015)... (PRWEB) , ... November 27, 2015 , ... ... of the well-respected Microsoft Dynamics SL User Group (MSDSLUG). Recognized as Microsoft’s official ... independent group of Microsoft Dynamics SL software users, partners, industry experts and representatives. ...
(Date:11/27/2015)... Minn. (PRWEB) , ... November 27, 2015 , ... ... start failing. Secura Consultants has prided itself for not only fulfilling the needs ... income protection solutions at an affordable price and providing top-tier customer service. However, ...
(Date:11/27/2015)... Angeles, CA (PRWEB) , ... November 27, 2015 , ... ... Commission on Accreditation of Allied Health Education Programs (CAAHEP) awarded accreditation to its Diagnostic ... list of CAAHEP accredited colleges, as only one of twelve colleges and universities in ...
Breaking Medicine News(10 mins):