Surgeon experience impacts type A aortic dissection patient mortality

摘要

Patient outcomes following acute type A dissection repair have previously been shown to be better at high-volume centers. It is uncertain whether improved outcomes are associated with greater surgeon experience or resources accessible at high-volume centers; this is the question Umana-Pizano and colleagues pursued ( ). They compared high versus low-volume surgeons at a high-volume aortic center to test the hypothesis that better outcomes following acute type A dissection repair may be primarily associated with surgeon experience and not with resources found at high-volume centers. They defined high-volume aortic surgeons (HVAS) as those who performed over ten cases per year. They found that the best outcomes were when an HVAS was the team leader (mortality 14.7%). Even when an HVAS was a secondary surgeon, mortality was higher (17.6%). The worst outcomes were in a team with two low-volume surgeons (mortality 24%), although numbers were too low to reach statistical significance.