Effect of Surgeons' Years of Experience on Outcomes of Acute Type A Aortic Dissection

Background The effect of surgeons' years of experience on the outcomes of acute type A aortic dissection (ATAAD) repair has not yet been studied. This study aimed to evaluate the association between the surgeon's years in practice and the outcomes of ATAAD repair. Methods Surgical records of ATAAD repairs performed at Saga University Hospital between 2004 and 2020 were reviewed. Surgeons were divided into two groups based on their surgical experience: late-career surgeons (LCSs) and early-career surgeons (ECSs) with ≥16 years and <16 of practice, respectively. The surgeons were designated as the primary surgeons or first assistants and grouped as follows: LCS-LCS, LCS-ECS, ECS-LCS, and ECS-ECS. Results During the study period, 25 primary surgeons performed 203 ATAAD repairs with 31 different first assistants: LCS-LCS, 50 repairs; LCS-ECS, 82 repairs; ECS-LCS, 55 repairs; and ECS-ECS, 16 repairs. The mean years in practice as a primary surgeon was 19.8 ± 3.3 for LCSs and 13.0 ± 1.8 for ECSs (p < 0.01). The unadjusted in-hospital mortality rates were 10.0%, 12.2%, 5.5%, and 6.3% for the LCS-LCS, LCS-ECS, ECS-LCS, and ECS-ECS groups, respectively (p = 0.63). Multivariable regression analysis showed that the surgeon's years of experience in practice were not a risk factor for in-hospital mortality. Furthermore, the long-term survival rate did not differ between the groups (p = 0.62). Conclusions The surgeons' years in practice had no effect on the outcomes of ATAAD repair. These investigations could aid in on-call coverage for ATAAD in medium-sized centers.