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Endoscopic Mitral Valve Surgery Learning Curve: The Impact Of Mentorship
Giacomo Bianchi, Rafik Margaryan, Marco Solinas.
Ospedale del Cuore - Fondazione Toscana "G. Monasterio", Massa, Italy.

OBJECTIVE: To explore the effect of mentorship on the learning curve of endoscopic mitral surgery.METHODS: from July 2015 to December 2020, 342 consecutive patients underwent endoscopic non rib spreading mitral surgery by two surgeons (surgeon A, surgeon B). Both surgeons, with different levels of experience, were already efficient in video-assisted minimally invasive mitral surgery. A step-wise approach to the mitral repair in this setting was planned. After an initial period of full mentoring by Surgeon A, the Surgeon B became independent in endoscopic approach; patients performed as independent surgeon are considered. Performance analysis was assessed by CUSUM curves.RESULTS: There were no substantial differences in repair efficiency between the two surgeons in degenerative pathology; there were no differences on the techniques used. There are also no differences in the rate of postoperative complications and outcomes. From the analysis of the individualized CUSUM curves, for surgeon A (mentor) the learning curve ended at 150 cases, whereas for surgeon B the learning curve ended at 50 cases.CONCLUSIONS: mentorship in endoscopic mitral surgery is achieved early when dedicated mentorship is present.


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