Our Summary

This research paper studied the relationship between the number of heart surgeries performed at hospitals in New York (NY) and the patients’ outcomes. The paper looked specifically at two types of heart surgery: coronary artery bypass grafting (CABG), which improves blood flow to the heart, and valve surgery, which repairs or replaces heart valves.

The researchers found a modest link between the outcomes of the two types of surgery. In other words, hospitals that were good at one type of surgery were often good at the other. However, this was not always the case. Two hospitals in NY had good outcomes for CABG but not for valve operations. There were no hospitals where the opposite was true.

The researchers also noticed that the number of surgeries a hospital performed affected the patients’ outcomes. This effect was stronger for valve operations than for CABG. This suggests that hospitals performing a higher volume of valve surgeries have better patient outcomes, indicating that these surgeries could benefit from being concentrated in fewer hospitals.

FAQs

  1. What is the relationship between the number of heart surgeries performed at hospitals and the patients’ outcomes according to the research?
  2. Did the research find any link between the outcomes of coronary artery bypass grafting (CABG) and valve surgery?
  3. What does the research suggest about hospitals performing a higher volume of valve surgeries?

Doctor’s Tip

A helpful tip a doctor might tell a patient about CABG is to choose a hospital that performs a high volume of these surgeries, as research shows that hospitals with more experience tend to have better patient outcomes. Additionally, it is important to follow all post-operative care instructions and attend follow-up appointments to ensure a successful recovery.

Suitable For

Patients who are typically recommended for CABG are those with severe coronary artery disease, including blockages in multiple vessels, those who have not responded well to other treatments such as medications or lifestyle changes, and those who have experienced a heart attack or other serious heart-related events. Additionally, patients with significant symptoms such as chest pain, shortness of breath, or reduced heart function may also be candidates for CABG. Patients who are at high risk for complications during the procedure, such as those with diabetes, kidney disease, or advanced age, may also be recommended for CABG.

Timeline

Before CABG:

  • Patient will undergo several tests and evaluations to determine the severity of their heart disease and if CABG is the best treatment option.
  • Patient may be prescribed medications to help manage their symptoms and improve heart function.
  • Patient will receive preoperative instructions and information on what to expect during and after the surgery.
  • Patient will be admitted to the hospital on the day of the surgery and preparations will be made for the procedure.

During CABG:

  • Patient will be placed under general anesthesia.
  • Surgeon will make an incision in the chest to access the heart.
  • Surgeon will take a healthy blood vessel from another part of the body (usually the leg) and graft it onto the blocked coronary artery to create a new pathway for blood flow.
  • Surgery can take several hours to complete depending on the number of blockages and complexity of the procedure.

After CABG:

  • Patient will be monitored closely in the intensive care unit (ICU) immediately after surgery.
  • Patient will gradually be moved to a regular hospital room as they recover.
  • Patient will receive physical therapy and education on how to care for themselves at home.
  • Patient will be prescribed medications to prevent blood clots, manage pain, and lower cholesterol.
  • Patient will need to attend follow-up appointments with their healthcare provider to monitor their progress and make any necessary adjustments to their treatment plan.

What to Ask Your Doctor

  1. How many CABG surgeries does the hospital perform annually, and what is the success rate for these procedures?
  2. Are there any specific risk factors or complications that I should be aware of before undergoing CABG surgery?
  3. What is the expected recovery time and rehabilitation process following CABG surgery?
  4. Are there any alternative treatment options to CABG that I should consider?
  5. How long will I need to stay in the hospital after CABG surgery, and what is the post-operative care plan?
  6. Will I need to make any lifestyle changes or follow a specific diet after undergoing CABG surgery?
  7. What are the potential long-term effects or complications of CABG surgery that I should be aware of?
  8. Are there any specific follow-up appointments or tests that I will need to undergo after CABG surgery?
  9. How experienced is the surgical team performing my CABG surgery, and what qualifications do they have?
  10. Are there any support groups or resources available for patients who have undergone CABG surgery for emotional or physical recovery?

Reference

Authors: Brooks C, Mori M, Shang M, Weininger G, Raul S, Dey P, Vallabhajosyula P, Geirsson A. Journal: J Card Surg. 2021 Feb;36(2):653-658. doi: 10.1111/jocs.15240. Epub 2020 Dec 18. PMID: 33336474