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Proximalized Total Arch Replacement Can Be Safely Performed by Trainee.

Sentaro Nakanishi¹, Naohiro Wakabayashi¹, Hayato Ise¹

¹Department of Cardiac Surgery, Asahikawa Medical University, Midorigaoka Higashi 2-1-1-1, Asahikawa 078-8510, Japan.

The Thoracic and Cardiovascular Surgeon

|July 8, 2020

Summary

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Total arch replacement (TAR) using a novel frozen elephant trunk device is safe for surgical education. Trainees can perform TAR safely, with no significant difference in outcomes compared to attending surgeons.

Area of Science:

Cardiovascular Surgery
Surgical Education
Aortic Surgery

Background:

Evaluating the safety of total arch replacement (TAR) using a novel frozen elephant trunk (FET) device.
Assessing the feasibility of TAR as a surgical training procedure.

Purpose of the Study:

To validate the safety and efficacy of total arch replacement (TAR) performed by trainees.
To determine if trainee-performed TAR yields comparable outcomes to those performed by experienced surgeons.

Main Methods:

Retrospective analysis of 64 patients undergoing TAR between April 2014 and March 2019.
Comparison of outcomes between 29 patients operated by trainees (group T) and 35 by attending surgeons (group A).

Main Results:

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Operative, cardiopulmonary bypass, and hypothermic circulatory arrest times were longer in the trainee group (group T) but aortic clamping time did not differ.
Thirty-day mortality was 3.1% across the cohort.
No significant difference in postoperative results, in-hospital mortality, major complications, late death, or aortic events between groups.

Conclusions:

Total arch replacement (TAR) can be safely performed by surgical trainees.
TAR is a viable and safe educational operation for training surgeons in complex aortic procedures.