Giant Right Atrial Cavernous Hemangioma Requiring Extensive Atrial Reconstruction

Area of Science:

• Cardiovascular Surgery
• Surgical Education
• Patient Safety

Background:

• Cardiac surgery requires extensive training for resident autonomy.
• Current training limitations hinder skill development for independent practice.
• Evaluating autonomous resident-led surgery is crucial for surgical education.

Purpose of the Study:

• To assess the safety and efficacy of "truly autonomous" cardiac surgery performed by senior residents without direct consultant supervision.
• To compare in-hospital and long-term outcomes of resident-led versus consultant-led cardiac surgeries.

Main Methods:

• Retrospective analysis of adult cardiac surgeries from January 2015 to December 2024.
• Propensity-score matching of 803 resident-led (Group R) and 803 consultant-led (Group C) cases.
• Comparison of in-hospital outcomes (mortality, complications, length of stay) and long-term survival.

Main Results:

• 1,606 matched patients (803 pairs) were analyzed.
• Demographics, preoperative characteristics, and operative times were comparable between groups.
• In-hospital outcomes and long-term survival were similar for resident-led and consultant-led cases, including in emergency procedures.

Conclusions:

• Autonomous cardiac surgery by senior residents is safe and feasible in appropriately selected cases.
• Outcomes for autonomous resident-led surgery are comparable to consultant-led procedures.
• Findings provide evidence for progressive independence in cardiac surgical training.