Our Summary

This study looked at whether having a cardiac surgery department in the same hospital could improve outcomes for patients undergoing certain types of chest surgery. They looked at data from almost 390,000 patients who had one of three types of chest surgery at hospitals with and without a cardiac surgery department. They found that patients who had two of the three types of surgery (lobectomy and esophagectomy) at hospitals with a cardiac surgery department were less likely to die during their hospital stay. Patients at these hospitals also had fewer overall complications from all three types of surgery. However, when they took into account other factors that could affect patient outcomes (like the number of surgeries the hospital performs and whether it’s a teaching hospital), having a cardiac surgery department didn’t make a difference. So, while it might look like having a cardiac surgery department improves outcomes for these patients, it’s more likely that other factors, like being a high-volume or teaching hospital, are the real reasons.

FAQs

  1. Does having a cardiac surgery department in the same hospital improve outcomes for patients undergoing chest surgery?
  2. Does the presence of a cardiac surgery department in a hospital affect the rate of complications from chest surgeries?
  3. Are there other factors that could affect patient outcomes besides the presence of a cardiac surgery department in a hospital?

Doctor’s Tip

A helpful tip a doctor might tell a patient about cardiac surgery is to follow all pre-operative instructions given by your healthcare team, such as fasting before surgery and stopping certain medications. It is also important to inform your healthcare team about any allergies or medical conditions you have. Additionally, make sure to follow all post-operative instructions for a successful recovery, including taking prescribed medications, attending follow-up appointments, and participating in cardiac rehabilitation if recommended. It is important to listen to your body and contact your healthcare provider if you experience any concerning symptoms after surgery.

Suitable For

Patients who are typically recommended for cardiac surgery include those with:

  1. Coronary artery disease: Patients with blocked or narrowed arteries that supply blood to the heart muscle may need coronary artery bypass grafting (CABG) surgery to improve blood flow to the heart.

  2. Heart valve disease: Patients with damaged or malfunctioning heart valves may require valve repair or replacement surgery to restore proper heart function.

  3. Congenital heart defects: Patients born with structural abnormalities in the heart may need surgery to correct these defects and improve heart function.

  4. Aortic aneurysm: Patients with a weakened or bulging aortic artery may require surgery to repair or replace the affected portion of the artery to prevent a potentially life-threatening rupture.

  5. Heart failure: Patients with severe heart failure that cannot be managed with medications or other treatments may be candidates for heart transplant or left ventricular assist device (LVAD) surgery to improve heart function.

  6. Arrhythmias: Patients with irregular heart rhythms that do not respond to medications or other treatments may require surgery, such as catheter ablation, to correct the rhythm disturbances.

  7. Other cardiac conditions: Patients with other complex or advanced heart conditions that cannot be effectively treated with medications or less invasive procedures may also be recommended for cardiac surgery.

Timeline

Before cardiac surgery:

  • Patient is diagnosed with a heart condition that requires surgical intervention.
  • Patient undergoes pre-operative testing, such as blood tests, imaging studies, and consultations with various healthcare providers.
  • Patient receives education about the surgery, risks, benefits, and post-operative care.
  • Patient may need to make lifestyle changes, such as quitting smoking or losing weight, before the surgery.

After cardiac surgery:

  • Patient is admitted to the hospital and undergoes the surgical procedure.
  • Patient is closely monitored in the intensive care unit (ICU) immediately following surgery.
  • Patient may require a ventilator to assist with breathing and medications for pain management.
  • Patient participates in physical therapy and other rehabilitation activities to aid in recovery.
  • Patient is discharged from the hospital and continues recovery at home, with follow-up appointments with their healthcare team.
  • Patient may need to make additional lifestyle changes, such as starting a cardiac rehabilitation program or taking medications as prescribed.

Overall, the timeline for a patient before and after cardiac surgery involves a comprehensive assessment, preparation, surgery, immediate post-operative care, rehabilitation, and long-term follow-up to ensure a successful recovery and improved quality of life.

What to Ask Your Doctor

  1. What specific type of cardiac surgery do I need and why?
  2. What are the risks and potential complications associated with this surgery?
  3. How experienced is the surgical team in performing this type of surgery?
  4. What is the success rate for this type of surgery at this hospital?
  5. What is the recovery process like and how long will it take?
  6. Are there any alternative treatment options to consider?
  7. What can I do to prepare for surgery and improve my chances of a successful outcome?
  8. What will my follow-up care look like after surgery?
  9. Are there any lifestyle changes or medications I should consider post-surgery?
  10. What symptoms should I watch out for that may indicate a complication or need for medical attention after surgery?

Reference

Authors: Nguyen AB, Selevany M, Turner AL, Langan RC, Sesti J, Paul S. Journal: Innovations (Phila). 2021 Mar-Apr;16(2):142-147. doi: 10.1177/1556984520976572. Epub 2021 Feb 3. PMID: 33533671