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Training for Multiple Arterial Grafting: A Thoracic Surgery Resident Survey
Neil Venardos1, T Brett Reece1, Joseph C Cleveland1
1Division of Cardiothoracic Surgery, Department of Surgery, Anschutz Medical Campus, University of Colorado, Aurora, Colorado.
The Annals of Thoracic Surgery
|October 17, 2020
Summary
Surgical trainees show significant interest in multiple arterial grafting (MAG) but lack experience with radial artery and skeletonized mammary artery techniques. Standardized training is needed to improve MAG utilization in the US.
Area of Science:
- Cardiovascular Surgery
- Thoracic Surgery Training
Background:
- Multiple arterial grafting (MAG) utilization in the US is under 10%.
- Trainee experience with MAG techniques, including radial artery (RA) and bilateral internal mammary artery (BIMA) grafts, has not been previously examined.
Purpose of the Study:
- To assess the current experience and perceived preparedness of surgical trainees regarding multiple arterial grafting (MAG).
Main Methods:
- An electronic survey was distributed to 497 thoracic surgery residents and 115 recent graduates.
- The survey queried experience with radial artery (RA) grafts and skeletonized mammary (SM) artery grafts for MAG.
Main Results:
- Only 14% of surveyed trainees responded (n=84).
- A significant majority lacked experience: 76% with RA harvest and 35% with SM harvest.
- Most trainees (68% for BIMA, 61% for RA) used these grafts in 0-5% of cases.
- Despite limited experience, 90% of trainees focused on cardiac/thoracic surgery desired to perform MAG in practice.
Conclusions:
- Substantial variation exists in MAG training among surgical residents.
- Trainees express strong interest in performing MAG, indicating a need for improved and standardized training protocols.
- Current training may not adequately prepare residents for widespread MAG utilization in the United States.
