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J Thorac Cardiovasc Surg 2006;132:1280-1284
© 2006 The American Association for Thoracic Surgery

Surgery for Congenital Heart Disease

The training of congenital heart surgeons

Division of Cardiothoracic Surgery, Emory University School of Medicine, Atlanta, Ga.

Read at the Thirty-second Annual Meeting of the Western Thoracic Surgical Association, Sun Valley, Idaho, June 21-24, 2006.

Received for publication June 10, 2006; revisions received July 5, 2006; accepted for publication August 11, 2006.

^_* Address for reprints: Brian E. Kogon, MD, Emory University, Children’s Healthcare of Atlanta, Egleston, Atlanta, GA 30322 (Email: Brian_kogon{at}emoryhealthcare.org).

OBJECTIVE: The training of congenital heart surgeons is extremely complex and challenging. It is frequently viewed as a 12-month fellowship followed by an apprenticeship. This study evaluates the initial experience of fellows training in pediatric heart surgery.

METHODS: Fellows completing 12 months of training within the past 5 years were included. Questionnaires were completed by E-mail, mail, or telephone correspondence.

RESULTS: Twenty-eight of 42 (67%) fellows responded from 11 training programs. Each fellow assisted in a mean of 294 (± 90) operations, 234 (± 86) of which were open, and each fellow performed a mean of 75 (± 53) operations, 51 (± 42) of which were open. Operations were grouped by risk-adjusted congenital heart surgery scores. Fellows were exposed to all groups as the assistant. As the surgeon, fellows typically performed operations only in groups 1, 2, and 3. Only 7 of 28 fellows performed operations in group 4, none in group 5, and 1 of 28 in group 6. On a scale of 1 to 10 (10 being satisfied), 28 of 28 fellows were satisfied with the exposure to congenital heart surgery (mean 9.5 ± 1.0), but only 10 of 28 with the operative experience (mean 4.9 ± 2.8). Twenty-six of 28 were satisfied with the training overall (mean 7.3 ±1.8).

CONCLUSIONS: Challenges in the training of congenital heart surgeons remain. Although fellows received excellent exposure to surgery for congenital heart disease, there is a perceived minimal operative experience as the surgeon, particularly for the more complex operations. There is dissatisfaction with the operative experience, yet the majority of fellows finish satisfied with their overall training.