Document Detail


Opposite trends in coronary artery and valve surgery in a large multisurgeon practice, 1979-1999.
MedLine Citation:
PMID:  14759424     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Trends in coronary artery bypass (CAB) and valve operations (VO) may help predict the future of cardiac surgery in the context of changing case mix, shifting paradigms, emerging technology, and population demographics. METHODS: We retrospectively reviewed all 30,319 adult CAB and VO in our group from 1979 to 1999 according to specific procedures. RESULTS: Coronary artery bypass volumes peaked in 1996 at 1,895 cases, declining 15.3% to 1,605 cases in 1999 with a decrease in risk profile and percent reoperations and an increase in mean age and percent octogenarians, prior percutaneous coronary interventions (PCI), left internal mammary artery (LIMA) graft usage, off-pump technology usage, and hospital mortality of reoperations. Right internal mammary grafts were employed infrequently and radial artery grafts transiently. Overall VO volumes continued to increase 24.0% since 1996, from 470 to 583 cases with a decreased risk profile, increased mean age, and percent octogenarians and prior PCI. The percentage of mechanical valve implants decreased, while the percentage of various tissue solutions for valve disease increased. Limited access incisions and port-access were employed transiently with CAB and VO. CONCLUSIONS: Coronary artery bypass volumes are decreasing, with an increasing percentage of LIMA grafts and off-pump cases. Valve operation volumes are steadily increasing, with a decreasing percentage of mechanical valve implants, in favor of various tissue solutions.
Authors:
William F Northrup; Robert W Emery; Demetre M Nicoloff; Theodore J Lillehei; Arlen R Holter; David P Blake
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  77     ISSN:  0003-4975     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  2004 Feb 
Date Detail:
Created Date:  2004-02-04     Completed Date:  2004-03-17     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  488-95     Citation Subset:  AIM; IM    
Affiliation:
Cardiac Surgical Associates, P.A., St. Paul, Minnesota, USA. north7@earthlink.net
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Angioplasty, Transluminal, Percutaneous Coronary / mortality,  trends
Coronary Artery Bypass / mortality,  trends*
Female
Group Practice / statistics & numerical data*
Health Status Indicators
Heart Valve Prosthesis Implantation / mortality,  trends*
Hospital Mortality / trends
Humans
Male
Middle Aged
Minnesota
Myocardial Revascularization / mortality,  trends
Reoperation / trends
Survival Rate
Utilization Review

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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