Some programs do have another “attending surgeon”. I prefer to have an experienced cardiothoracic physician assistant (PA) and a senior fellow assist me. These individuals have years of operative experience and my preference for this approach is based on the reality that they often lack the “ego” that attending surgeons have! That being said, if I ever needed another attending to help in a crisis, I have great relationships with several partners who could lend assistance if needed and I would never hesitate to ask for help if needed. Your safety is my #1 priority!