Transcatheter cardiac procedures have generated increasing interest in trainees and
training programs alike. Using the modified Delphi method, we sought to clarify the
transcatheter competencies that cardiac surgery residents should be expected to attain
by the completion of training.
METHODS AND RESULTS
Individuals with expertise in transcatheter structural heart and aortic procedures
were recruited across Canada. A questionnaire was prepared using a 5-point Likert
scale. During two rounds participants rated the competencies that they felt cardiac
surgery residents should be required to achieve to perform transcatheter procedures.
Data was analyzed and presented to participants between rounds. Competencies rated
4 or higher by at least 80% of respondents after the second round were considered
fundamental to transcatheter cardiac surgical training. A total of 46 individuals
participated in the study including 23 cardiac surgeons, 17 interventional cardiologists
and 6 vascular surgeons. Participants with relevant experience performed a median
of 75 (interquartile range 40 – 100) transcatheter aortic valve implantations in the
prior year as primary or secondary operator and 15 (interquartile range 11 – 35) thoracic
endovascular aortic repairs in the prior two years as primary operator. Median clinical
and teaching experience consisted of 13 (interquartile range 7 – 19.5) years in practice
and 8.5 (interquartile range 5- 15) residents taught per year, respectively. Of the
included competencies, 53 were considered fundamental to transcatheter cardiac surgical
The identified fundamental competencies can be used to develop educational strategies
during transcatheter cardiac surgery training. Future efforts should focus on collecting
evidence for their validity.