Our Summary

This study looked at whether it is safe for surgical residents (doctors in training) to perform major heart operations, and whether the outcomes of these surgeries were different compared to those done by experienced surgeons (consultants).

The researchers looked at data from 5894 heart surgeries performed from 2013 to 2018 - some by trainees, and some by consultants. They found that trainees performed just over half of these surgeries. They also looked at various factors that could affect the outcome of the surgery, like whether the patient had kidney disease or whether the surgery was an emergency.

The results showed that having kidney disease, peripheral vascular disease (a circulatory condition), or needing an emergency procedure were all factors that could increase the likelihood of dying in the hospital. However, needing an emergency procedure was the only factor that could make the overall outcome worse (taking into account things like the length of hospital stay, whether the patient needed dialysis, had a stroke, died in the hospital, or needed another operation).

When they compared the outcomes of surgeries done by trainees to those done by consultants, they found that the two groups were similar. However, trainees took longer to perform certain procedures. Despite this, the overall outcome was slightly better for patients operated on by trainees, mainly because their hospital stays were shorter.

In conclusion, this study suggests that it is safe for trainees to perform major heart surgeries and that the quality of patient care is not compromised.

FAQs

  1. Is it safe for surgical residents to perform major heart operations?
  2. How does the outcome of heart surgeries performed by surgical residents compare to those performed by experienced surgeons?
  3. What factors can increase the likelihood of a worse outcome in heart surgeries?

Doctor’s Tip

A helpful tip a doctor might tell a patient about cardiac surgery is to trust in the training and expertise of the surgical team, even if the surgery is being performed by a surgical resident. This study shows that outcomes for heart surgeries performed by trainees are similar to those done by experienced surgeons, and in some cases, may even have slightly better outcomes. It’s important to follow the recommendations and guidelines provided by your healthcare team before and after surgery to ensure the best possible outcome.

Suitable For

Patients who are typically recommended for cardiac surgery are those with conditions such as coronary artery disease, valvular heart disease, heart failure, congenital heart defects, and arrhythmias. These patients may have symptoms such as chest pain, shortness of breath, fatigue, palpitations, or swelling in the legs, indicating that their heart function is compromised and may benefit from surgical intervention. Additionally, patients with risk factors such as diabetes, high blood pressure, high cholesterol, obesity, smoking, or a family history of heart disease may also be candidates for cardiac surgery to prevent future complications.

Timeline

However, further research is needed to determine the long-term outcomes and potential complications of surgeries performed by trainees compared to those done by experienced consultants. The timeline for a patient before and after cardiac surgery typically involves pre-operative assessments, surgery, recovery in the hospital, and post-operative follow-up care. Patients may experience pain, discomfort, fatigue, and limited mobility in the days and weeks following surgery, but with proper care and rehabilitation, they can gradually resume their normal activities and improve their overall quality of life.

What to Ask Your Doctor

Some questions a patient should ask their doctor about cardiac surgery include:

  1. What is the success rate of the specific cardiac surgery I need?
  2. How many times have you performed this particular surgery?
  3. Will there be a team of experienced surgeons assisting during the surgery?
  4. What are the potential risks and complications associated with this surgery?
  5. How long is the recovery process expected to be?
  6. What can I do to prepare for the surgery and improve my chances of a successful outcome?
  7. Will I need to follow a specific post-operative care plan or participate in cardiac rehabilitation?
  8. Are there any alternative treatment options to consider?
  9. How will my progress be monitored after the surgery?
  10. What lifestyle changes should I make after the surgery to maintain heart health?

Reference

Authors: Luthra S, Leiva-Juarez MM, Ismail AH, Tsang GM, Barlow CW, Velissaris T, Miskolczi S, Ohri SK. Journal: Ann Thorac Surg. 2020 Oct;110(4):1404-1411. doi: 10.1016/j.athoracsur.2020.02.009. Epub 2020 Mar 10. PMID: 32165177