Purpose of review: Randomized controlled trials (RCTs) are the gold standard for determining the difference between two alternative treatments and produce level I evidence which serves as the basis of clinical practice guidelines. The purpose of this review is to critically analyze RCTs involving cardiac surgery and demonstrate how RCTs have impacted cardiac surgeons over the past two decades. Recent findings: Three recent RCTs may significantly impact the treatment of coronary artery and valvular heart disease: SYNTAX, ART, and PARTNER. These trials are reviewed and their importance to cardiac surgeons is discussed. Summary: Cardiac surgeons must be able to critically analyze RCTs, so that any potential bias can be uncovered which may influence the interpretation of the data and the trial's reported conclusions. It is important for cardiac surgeons to read and understand the major RCTs involving cardiac surgery, as they provide the strongest evidence when choosing between treatment options for patients with cardiac disease.
- coronary artery bypass
- external validity
- randomized controlled trials
- transcatheter aortic valve implantation