Off-pump coronary operations can be safely taught to cardiothoracic trainees

Background. Off-pump coronary artery bypass (OPCAB) operations are evolving rapidly and becoming established in many cardiothoracic centers. For the t echnique to be widely applicable, teaching methods must be developed for su rgical trainees. Early and midterm clinical outcomes of OPCAB performed at our institution by trainees as first operators under supervision were compa red to those obtained in patients operated on by consultants. Methods. Analysis was undertaken on data prospectively inserted in the Pati ent Analysis & Tracking System . Of the 559 OPCAB operations performed betw een January 1997 and May 2000, 124 (22%) were carried out by a supervised t rainee and 435 (78%) by a consultant. Results. There was no difference in age, sex, angina class, New York Heart Association functional class, or operative priority and extent of coronary artery disease in the two groups. More patients operated on by consultants had a history of congestive heart failure requiring medical therapy, signif icantly lower ejection fraction, and higher Parsonnet score compared with p atients operated on by trainees. Early and midterm clinical results, in ter ms of morbidity and mortality, were similar in patients operated on by trai nees or by consultants. Conclusions. Our data show no differences in early and midterm clinical out come for patients undergoing OPCAB operations performed either by consultan ts or by trainees under supervision. The improvements in exposure and stabi lization techniques, as well as the use of intracoronary shunts, have made it possible and safe to teach trainees off-pump multivessel coronary artery revascularization. (C) 2001 by The Society of Thoracic Surgeons.