title: How safe is it to train residents to perform mitral valve surgery?
abstract: A best evidence topic was constructed according to a structured protocol. The enquiry: In [patients undergoing mitral valve surgery] are [postoperative morbidity and mortality outcomes] acceptable when patients are operated on by [residents]? Four hundred and twenty-three were identified from the search strategy. Six articles selected as best evidence were tabulated. All current published evidence, encompassing open and minimally invasive mitral valve repair in addition to mitral valve replacement, supports the involvement of trainees in mitral procedures. Although trainees may experience longer aortic cross-clamp and cardiopulmonary bypass times than specialist surgeons, they are not associated with significantly worse perioperative or postoperative outcomes in comparable mitral procedures. Important factors in the viability of mitral valve training and its quality include the volume of cases per institution and the expertise of the supervising surgeon, and these remain largely unexplored. Overall, mitral valve surgery remains a valuable potential training opportunity, one which is perhaps underexploited.
authors.affiliation: Royal Bournemouth Hospital, Bournemouth, UK jgabriel@doctors.org.uk j.gabriel1@uni.bsms.ac.uk.
authors.forename: Joseph
authors.initials: J
authors.lastname: Gabriel
authors.affiliation: Wessex Cardiothoracic Centre, Southampton University Hospital NHS Trust, Southampton, UK.
authors.forename: László
authors.initials: L
authors.lastname: Göbölös
authors.affiliation: Wessex Cardiothoracic Centre, Southampton University Hospital NHS Trust, Southampton, UK.
authors.forename: Szabolcs
authors.initials: S
authors.lastname: Miskolczi
authors.affiliation: Wessex Cardiothoracic Centre, Southampton University Hospital NHS Trust, Southampton, UK.
authors.forename: Clifford
authors.initials: C
authors.lastname: Barlow
mesh_terms: D002983:Clinical Competence; D004503:Education, Medical, Graduate / Q000379:methods*; D006349:Heart Valve Diseases / Q000601:surgery*; D019918:Heart Valve Prosthesis Implantation / Q000193:education*; D006801:Humans; D007396:Internship and Residency; D008943:Mitral Valve / Q000601:surgery*; D066231:Surgeons / Q000193:education*; D016896:Treatment Outcome
keywords: Mitral valve; Mitral valve repair; Mitral valve replacement; Outcomes; Systematic review; Training