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Ann Thorac Surg 2000;70:479-482
© 2000 The Society of Thoracic Surgeons
a Division of Cardiothoracic Surgery and Center for Minimally Invasive Cardiac Surgery, Buffalo General Hospital and SUNY at Buffalo, Buffalo, New York, USA
b Department of Surgery, University of California at San Diego, San Diego, California, USA
Address reprint requests to Dr Hratch Karamanoukian, Division of Cardiothoracic Surgery, Buffalo General Hospital, 100 High St, Buffalo, NY 14203
e-mail: lisbon5{at}yahoo.com
Background. "Off-pump" coronary artery operations are done with increasing frequency in the treatment of coronary artery disease. As a result, residents in thoracic surgery have been confronted with the necessity of gaining experience in this innovative approach to coronary surgery. The aim of this study was to assess the importance of training in minimally invasive coronary revascularization as it was perceived by thoracic surgery residents.
Methods. A postal, multiple-choice survey questionnaire was sent to all cardiothoracic surgery residents (n = 327) of accredited training programs in the United States. Responses were tabulated and analyzed.
Results. The overall response rate was 68% (222 of 327 residents). The attending staff was very interested (37%), or had some interest (63%), in beating heart coronary revascularization. Ninety-eight percent of the programs had at least one surgeon performing off-pump procedures. Although 88% of the responding residents showed some interest in off-pump coronary operations, only 22% of them had performed more than 20 off-pump cases, and even less (12%) had performed more than 20 cases of off-pump complete revascularization, or off-pump circumflex revascularization (4%). Sixteen percent of them had no clinical experience with these techniques. Regarding career intentions, 88% of the residents indicated that off-pump coronary operations were expected to be part of the practice, and 58% of them were interested in pursuing additional training in less invasive heart procedures.
Conclusions. The results of this survey suggest that training in off-pump coronary revascularization is variable across training programs, and that the majority of residents may not reach proficiency in coronary procedures on the beating heart during their residency. This may adversely affect their future expectations, as 88% of them would like to practice off-pump coronary surgery once the training is completed.
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