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Proximalized Total Arch Replacement Can Be Safely Performed by Trainee.

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Citation: Thoracic & Cardiovascular Surgeon. 2020 Jul 07PMID: 32634833Institution: MedStar Heart & Vascular InstituteForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: IN PROCESS -- NOT YET INDEXEDYear: 2020 ISSN:

0171-6425

Name of journal: The Thoracic and cardiovascular surgeonAbstract: BACKGROUND: The aim of the present study was to validate safety of total arch replacement (TAR) using a novel frozen elephant trunk device, operated by trainees as surgical education.CONCLUSIONS: The present study demonstrated that TAR can be safely performed by trainees, and suggests TAR as a possible and safe educational operation. Copyright Georg Thieme Verlag KG Stuttgart . New York.METHODS: Sixty-four patients including 19 patients (29.6%) with acute aortic dissection type A (AADA) underwent TAR in our institute between April 2014 and March 2019 were retrospectively analyzed. Twenty-nine patients were operated by trainees (group T) and 35 patients were operated by attending surgeons (group A).RESULTS: Patient characteristics did not differ between groups. Operative time (409.4 +/- 87.8 vs. 468.6 +/- 129.6 minutes, p = 0.034), cardiopulmonary bypass time (177.7 +/- 50.4 vs. 222.9 +/- 596.7 minutes, p = 0.019), and hypothermic circulatory arrest time (39.5 +/- 13.4 vs. 54.5 +/- 18.5 minutes, p = 0.001) were significantly shorter in group A than in group T, but aortic clamping time did not differ between groups (115.3 +/- 55.7 vs. 114.2 +/- 35.0 minutes, p = 0.924) because the rate of concomitant surgery was higher in group A (37.1 vs. 10.3%, p = 0.014). Thirty-day mortality was 3.1% in the entire cohort. Although operation time was longer in group T, there were no significant difference in postoperative results between the groups, and the experience levels of the main operator were not independent predictors for in-hospital mortality + major postoperative complications. There was no difference in late death and aortic events between groups.All authors: Hirofuji A, Ise H, Ishikawa N, Kamiya H, Kitahara H, Nakanishi S, Wakabayashi NFiscal year: FY2021Digital Object Identifier:

https://dx.doi.org/10.1055/s-0040-1713354

Date added to catalog: 2020-08-26

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Item type	Current library	Collection	Call number	Status	Date due	Barcode
Journal Article	MedStar Authors Catalog	Article	32634833	Available		32634833

BACKGROUND: The aim of the present study was to validate safety of total arch replacement (TAR) using a novel frozen elephant trunk device, operated by trainees as surgical education.

CONCLUSIONS: The present study demonstrated that TAR can be safely performed by trainees, and suggests TAR as a possible and safe educational operation. Copyright Georg Thieme Verlag KG Stuttgart . New York.

METHODS: Sixty-four patients including 19 patients (29.6%) with acute aortic dissection type A (AADA) underwent TAR in our institute between April 2014 and March 2019 were retrospectively analyzed. Twenty-nine patients were operated by trainees (group T) and 35 patients were operated by attending surgeons (group A).

RESULTS: Patient characteristics did not differ between groups. Operative time (409.4 +/- 87.8 vs. 468.6 +/- 129.6 minutes, p = 0.034), cardiopulmonary bypass time (177.7 +/- 50.4 vs. 222.9 +/- 596.7 minutes, p = 0.019), and hypothermic circulatory arrest time (39.5 +/- 13.4 vs. 54.5 +/- 18.5 minutes, p = 0.001) were significantly shorter in group A than in group T, but aortic clamping time did not differ between groups (115.3 +/- 55.7 vs. 114.2 +/- 35.0 minutes, p = 0.924) because the rate of concomitant surgery was higher in group A (37.1 vs. 10.3%, p = 0.014). Thirty-day mortality was 3.1% in the entire cohort. Although operation time was longer in group T, there were no significant difference in postoperative results between the groups, and the experience levels of the main operator were not independent predictors for in-hospital mortality + major postoperative complications. There was no difference in late death and aortic events between groups.

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