Conventional aortic valve replacement can be safely done by very early stage trainee

Area of Science:

• Cardiovascular Surgery
• Surgical Education

Background:

• Conventional aortic valve replacement (AVR) using median sternotomy is considered a safe approach.
• An aggressive training program allows even early-stage trainees to perform surgical AVR (SAVR) under supervision.

Purpose of the Study:

• To evaluate the outcomes of trainee surgeons performing SAVR under supervision.
• To determine if an aggressive training program for SAVR is justified.

Main Methods:

• Retrospective analysis of 145 patients undergoing isolated SAVR between January 2015 and April 2024.
• Comparison of outcomes between staff surgeons (n=91) and resident surgeons (n=54) with 2-6 years of experience.
• Outcomes assessed included preoperative characteristics, intraoperative metrics, postoperative complications, and survival rates.

Main Results:

• No significant differences were observed in operative time or aortic cross-clamp time between staff and resident surgeons.
• Early postoperative mortality and mid-term survival rates were comparable between the two groups.
• Despite higher Japan SCORE for staff surgeons, residents achieved similar clinical outcomes.

Conclusions:

• Surgical aortic valve replacement (SAVR) can be performed safely by early-stage trainees.
• Proper case selection and supervision are crucial for successful outcomes in trainee-performed SAVR.