Can We Safely Train Cardiothoracic Surgical Residents to Perform Emergency Surgery? A 10-Year Propensity-Matched Analysis 

This 10-year, single institution propensity-matched study investigated the outcomes of supervised resident-led emergency cardiac surgery compared to consultant-led procedures. Among 1,241 emergency cases, 364 matched pairs were analyzed, and overall outcomes were noted to be similar. Despite longer cardiopulmonary bypass times in consultant-led cases—possibly suggesting greater complexity—there were no significant differences in in-hospital mortality (13.7 percent vs 13.5 percent), major complications, or long-term survival up to 10 years. Subgroup analyses focusing on high-risk cases, emergent revascularization, infective endocarditis, and acute aortic syndromes confirmed comparable outcomes. The authors suggest that these findings validate structured training programs that progressively increase resident autonomy under supervision, addressing concerns about reduced training duration and working-hour restrictions. The study supports the safety and efficacy of resident involvement in high-stakes emergency cardiac surgery, demonstrating that appropriate supervision enables skill development without compromising patient outcomes.