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American Heart Association Journal Report: Surgical Residents Perform Heart Surgery as Effectively as Staff Surgeons
Date:9/30/2008

es 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 su
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SOURCE American Heart Association
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All rights reserved

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