Surgical learning curve: factors in minimally invasive mitral valve surgery

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1. Between 75 and 125 minimally invasive mitral valve surgeries needed to be performed by surgeons to overcome the learning curve for this procedure.

2. Surgeons needed to perform the operation more than once per week to sustain results.

Evidence Rating Level: 2 (Good)

Study Rundown: The surgical learning curve, a tool that monitors performance of individual surgeons over time, has been used to evaluate the experience necessary to perform a surgery safely with minimal morbidity and mortality. This study found 75-125 operations were required for mastery among average cardiac surgeons in their institution.

Click to read the study in Circulation

In-Depth: The operative experience of 17 surgeons at a single institution performing minimally invasive mitral valve repair was reviewed. 3895 operations in total were analyzed from a prospective database, including each surgeons’ first case. Learning curves were based on operation duration and incidence of a composite endpoint of major complications. With regards to complications, eight surgeons acquired mastery in the “classical” learning curve of 75-125 cases, five surgeons outperformed with fewer complications from the beginning, and four surgeons underperformed with high complication rates despite experience. The operative time changes did not follow a learning curve.

By Gina Siddiqui and Allen Ho

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