Our Summary
In simpler terms, this research study was conducted to find out whether the experience level of the surgeon performing a coronary artery bypass graft (CABG) surgery, a common type of heart surgery, affects the outcome of the operation. The researchers compared results from surgeries performed by fully qualified doctors (consultants) and doctors-in-training (trainees).
The researchers looked at 16 previous studies involving over 50,000 patients. They found that surgeries performed by trainees took a bit longer, but overall, the outcomes were similar to those performed by consultants. This applied to the rates of death during or shortly after surgery, as well as complications such as stroke, heart attack, kidney failure, needing another operation due to bleeding, or wound infection. They also found that the experience level of the surgeon didn’t seem to affect the patient’s chance of survival in the medium term.
A smaller subset of the studies looked specifically at a type of CABG surgery that doesn’t use a heart-lung machine (off-pump CABG). Again, the research found no difference in the rates of death or complications between surgeries performed by trainees and those performed by consultants.
The conclusion is that, with the right supervision, trainee surgeons can perform CABG surgeries without negatively affecting the patient’s outcomes or survival in the medium term. However, the researchers suggest more studies are needed to understand the impact of a trainee surgeon on the long-term results of off-pump CABG surgeries.
FAQs
- Does the experience level of the surgeon performing a coronary artery bypass graft (CABG) surgery affect the outcome of the operation?
- Is there a difference in the rates of death or complications between CABG surgeries performed by trainees and those performed by consultants?
- Are more studies needed to understand the impact of a trainee surgeon on the long-term results of off-pump CABG surgeries?
Doctor’s Tip
A helpful tip a doctor might give a patient about coronary artery bypass surgery is that the experience level of the surgeon performing the surgery may not significantly impact the outcome or survival in the medium term. It is important for patients to trust in their medical team and follow post-operative care instructions to ensure the best possible recovery.
Suitable For
Patients who are typically recommended for coronary artery bypass graft (CABG) surgery are those with severe coronary artery disease, which is a buildup of plaque in the arteries that supply blood to the heart. These patients may have symptoms such as chest pain, shortness of breath, or fatigue, despite medical treatment. Additionally, patients who have blockages in multiple coronary arteries or have not responded well to other treatments like medications or lifestyle changes may be recommended for CABG surgery.
Overall, the findings of the research suggest that the experience level of the surgeon, whether they are a consultant or a trainee, does not significantly impact the outcomes or survival of patients undergoing CABG surgery. This means that patients can have confidence in the skills of trainee surgeons, as long as they are properly supervised. More research is needed to fully understand the long-term impact of trainee surgeons on specific types of CABG surgeries.
Timeline
Before the surgery, the patient may experience symptoms of coronary artery disease such as chest pain (angina), shortness of breath, fatigue, or dizziness. They may undergo diagnostic tests such as an electrocardiogram (ECG), stress test, or coronary angiography to determine the extent of blockages in their coronary arteries.
After the surgery, the patient will be closely monitored in the intensive care unit (ICU) for a few days. They may experience pain, swelling, or bruising at the incision site. They will gradually begin physical therapy to regain strength and mobility. The patient will be prescribed medications to manage pain, prevent infections, and control blood pressure and cholesterol levels.
Over time, the patient will need to make lifestyle changes such as adopting a heart-healthy diet, quitting smoking, exercising regularly, and managing stress. They will have follow-up appointments with their healthcare provider to monitor their progress and adjust their treatment plan as needed. With proper care and adherence to medical advice, the patient can improve their overall heart health and quality of life after undergoing coronary artery bypass surgery.
What to Ask Your Doctor
Some questions a patient should ask their doctor about coronary artery bypass surgery include:
- How experienced is the surgeon who will be performing my coronary artery bypass surgery?
- What is the success rate of this surgeon in performing coronary artery bypass surgeries?
- Are there any potential complications or risks associated with this surgery, and how will they be managed?
- What is the recovery process like after coronary artery bypass surgery, and what can I expect in terms of pain and limitations?
- Will I need any follow-up care or rehabilitation after the surgery?
- How long will it take for me to fully recover and return to my normal activities?
- Are there any lifestyle changes or medications I will need to take after the surgery to maintain heart health?
- What signs or symptoms should I watch out for that may indicate a problem after the surgery?
- Are there any alternative treatment options to coronary artery bypass surgery that I should consider?
- How often will I need follow-up appointments to monitor my heart health after the surgery?
Reference
Authors: Virk SA, Bowman SRA, Chan L, Bannon PG, Aty W, French BG, Saxena A. Journal: J Thorac Cardiovasc Surg. 2016 Mar;151(3):647-654.e1. doi: 10.1016/j.jtcvs.2015.11.006. Epub 2015 Nov 11. PMID: 26707761