Outcomes of acute type A aortic dissection operations performed by early-career cardiovascular surgeonsCentral MessagePerspective
Objective: Surgical outcomes of acute type A aortic dissection have been recognized to be associated with the surgical volume of individual hospitals and surgeons. In this study, we aimed to investigate the results and learning curves of acute type A aortic dissection operations performed by early-c...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2021-06-01
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| Series: | JTCVS Open |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666273621000620 |
| _version_ | 1818775434968432640 |
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| author | Ting-Wei Lin, MD, MSc Meng-Ta Tsai, MD Hsuan-Yin Wu, MD Yi-Chen Wang, MD Yu-Ning Hu, MD Chung-Dann Kan, MD, PhD Jun-Neng Roan, MD, PhD Chwan-Yau Luo, MD, MSc |
| author_facet | Ting-Wei Lin, MD, MSc Meng-Ta Tsai, MD Hsuan-Yin Wu, MD Yi-Chen Wang, MD Yu-Ning Hu, MD Chung-Dann Kan, MD, PhD Jun-Neng Roan, MD, PhD Chwan-Yau Luo, MD, MSc |
| author_sort | Ting-Wei Lin, MD, MSc |
| collection | DOAJ |
| description | Objective: Surgical outcomes of acute type A aortic dissection have been recognized to be associated with the surgical volume of individual hospitals and surgeons. In this study, we aimed to investigate the results and learning curves of acute type A aortic dissection operations performed by early-career cardiovascular surgeons. Methods: A total of 248 surgical repairs of acute type A aortic dissections were conducted at a tertiary medical center between 2010 and 2018. By using the cumulative sum test, cardiovascular surgeons in their early career were identified, and their performances were assessed. The outcomes of patients who were operated by early-career cardiovascular surgeons were compared with those by experienced or senior surgeons. Results: During the study period, 202 (81.5%) of the 248 acute type A aortic dissection operations were performed primarily by the 4 newly appointed attending cardiovascular surgeons. In cumulative sum curves, all surgeons exhibited a steady performance throughout the study period. On the basis of our institutional result of acute type A aortic dissection operation, early career was defined as performing fewer than 32 acute type A aortic dissection operations. The 30-day mortality rates of acute type A aortic dissection operations performed by early-career surgeons were equivalent to those performed by experienced/senior surgeons (10.9% vs 12.5%, P = .844). There was also no difference in mid-term overall survival and aortic event-free survival between the 2 groups (P = .638 and P = .574, respectively). Conclusions: In a center with a well-established program, cardiovascular surgeons could accomplish surgical repair of acute type A aortic dissection with adequate early- and mid-term results from the initiation of their careers. |
| first_indexed | 2024-12-18T10:56:59Z |
| format | Article |
| id | doaj.art-4f7cd53340cc4d529e5bddc2d00be372 |
| institution | Directory Open Access Journal |
| issn | 2666-2736 |
| language | English |
| last_indexed | 2024-12-18T10:56:59Z |
| publishDate | 2021-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | JTCVS Open |
| spelling | doaj.art-4f7cd53340cc4d529e5bddc2d00be3722022-12-21T21:10:19ZengElsevierJTCVS Open2666-27362021-06-016110Outcomes of acute type A aortic dissection operations performed by early-career cardiovascular surgeonsCentral MessagePerspectiveTing-Wei Lin, MD, MSc0Meng-Ta Tsai, MD1Hsuan-Yin Wu, MD2Yi-Chen Wang, MD3Yu-Ning Hu, MD4Chung-Dann Kan, MD, PhD5Jun-Neng Roan, MD, PhD6Chwan-Yau Luo, MD, MSc7Division of Cardiovascular Surgery, Department of Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Division of Cardiovascular Surgery, Department of Surgery, E-DA Hospital and College of Medicine, I-Shou University, Kaohsiung, Taiwan; Address for reprints: Ting-Wei Lin, MD, MSc, Division of Cardiovascular Surgery, Department of Surgery, E-DA Hospital. No.1, Yida Rd, Jiaosu Village, Yanchao District, Kaohsiung City 82445, Taiwan.Division of Cardiovascular Surgery, Department of Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, TaiwanDivision of Cardiovascular Surgery, Department of Surgery, E-DA Hospital and College of Medicine, I-Shou University, Kaohsiung, TaiwanDivision of Cardiovascular Surgery, Department of Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, TaiwanDivision of Cardiovascular Surgery, Department of Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, TaiwanDivision of Cardiovascular Surgery, Department of Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, TaiwanDivision of Cardiovascular Surgery, Department of Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, TaiwanDivision of Cardiovascular Surgery, Department of Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Division of Cardiovascular Surgery, Department of Surgery, E-DA Hospital and College of Medicine, I-Shou University, Kaohsiung, TaiwanObjective: Surgical outcomes of acute type A aortic dissection have been recognized to be associated with the surgical volume of individual hospitals and surgeons. In this study, we aimed to investigate the results and learning curves of acute type A aortic dissection operations performed by early-career cardiovascular surgeons. Methods: A total of 248 surgical repairs of acute type A aortic dissections were conducted at a tertiary medical center between 2010 and 2018. By using the cumulative sum test, cardiovascular surgeons in their early career were identified, and their performances were assessed. The outcomes of patients who were operated by early-career cardiovascular surgeons were compared with those by experienced or senior surgeons. Results: During the study period, 202 (81.5%) of the 248 acute type A aortic dissection operations were performed primarily by the 4 newly appointed attending cardiovascular surgeons. In cumulative sum curves, all surgeons exhibited a steady performance throughout the study period. On the basis of our institutional result of acute type A aortic dissection operation, early career was defined as performing fewer than 32 acute type A aortic dissection operations. The 30-day mortality rates of acute type A aortic dissection operations performed by early-career surgeons were equivalent to those performed by experienced/senior surgeons (10.9% vs 12.5%, P = .844). There was also no difference in mid-term overall survival and aortic event-free survival between the 2 groups (P = .638 and P = .574, respectively). Conclusions: In a center with a well-established program, cardiovascular surgeons could accomplish surgical repair of acute type A aortic dissection with adequate early- and mid-term results from the initiation of their careers.http://www.sciencedirect.com/science/article/pii/S2666273621000620acute type A aortic dissectionearly-career surgeonsoutcomeCUSUM analysis |
| spellingShingle | Ting-Wei Lin, MD, MSc Meng-Ta Tsai, MD Hsuan-Yin Wu, MD Yi-Chen Wang, MD Yu-Ning Hu, MD Chung-Dann Kan, MD, PhD Jun-Neng Roan, MD, PhD Chwan-Yau Luo, MD, MSc Outcomes of acute type A aortic dissection operations performed by early-career cardiovascular surgeonsCentral MessagePerspective JTCVS Open acute type A aortic dissection early-career surgeons outcome CUSUM analysis |
| title | Outcomes of acute type A aortic dissection operations performed by early-career cardiovascular surgeonsCentral MessagePerspective |
| title_full | Outcomes of acute type A aortic dissection operations performed by early-career cardiovascular surgeonsCentral MessagePerspective |
| title_fullStr | Outcomes of acute type A aortic dissection operations performed by early-career cardiovascular surgeonsCentral MessagePerspective |
| title_full_unstemmed | Outcomes of acute type A aortic dissection operations performed by early-career cardiovascular surgeonsCentral MessagePerspective |
| title_short | Outcomes of acute type A aortic dissection operations performed by early-career cardiovascular surgeonsCentral MessagePerspective |
| title_sort | outcomes of acute type a aortic dissection operations performed by early career cardiovascular surgeonscentral messageperspective |
| topic | acute type A aortic dissection early-career surgeons outcome CUSUM analysis |
| url | http://www.sciencedirect.com/science/article/pii/S2666273621000620 |
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