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J Thorac Cardiovasc Surg 2006;131:14-15
© 2006 The American Association for Thoracic Surgery

Editorial

Attitude toward and application of off-pump coronary artery bypass after continuing education retraining

Richard J. Novick, MD * , Michael W. Chu, MD

Department of Cardiac Surgery London Health Science Center, London, Ontario, Canada.

Received for publication August 22, 2005; accepted for publication August 29, 2005.

* Address for reprints: Richard J. Novick, MD, Division of Cardiac Surgery, London Health Sciences Centre, University Hospital 339 Windermere Road, London, ON N6A 5A5, Canada. (Email: richard.novick@lhsc.on.ca).

The first 20% of the full text of this article appears below.

GoThe objective of this provocative article by Albert and associates 1 Go was to study the impact of a 2-day, multimodal, continuing medical education and retraining course on the subsequent attitude toward, application of, and "complexity score" of off-pump coronary artery bypass grafting (OPCAB). The authors of this paper reengineered their institution toward OPCAB for all patients and all surgeons 6 years ago and had extensive prior experience in providing multimodal individual training to surgeon and anesthesia teams for this procedure. In addition, Dr Sargeant's team has a venerable track record in coronary artery bypass outcome analysis. The prospective benefits of OPCAB for all patients remain controversial, and our recent meta-analysis of randomized controlled trials showed no significant reduction in mortality, stroke, or perioperative myocardial infarction rates with OPCAB as compared with conventional on-pump coronary artery bypass. 2 Go Nonetheless, secondary outcomes such as postoperative ventilation time, atrial fibrillation rates, and intensive care unit and hospital lengths of stay were significantly reduced after the former procedure. Research at our center has also shown that the transition from routine on-pump coronary artery bypass to OPCAB can be accomplished safely, 3 Go even without the multimodal surgical team training described by the authors of this article. Despite these findings, the undeniable fact is . . . [Full Text of this Article]


Related Article

Performance analysis of interactive multimodal CME retraining on attitude toward and application of OPCAB
Alexander Albert, Eric A. Peck, Patrick Wouters, Jan Van Hemelrijck, Christophe Bert, and Paul Sergeant
J. Thorac. Cardiovasc. Surg. 2006 131: 154-162. [Abstract] [Full Text] [PDF]





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