Hospital Volume and Outcome after Bilateral Internal Mammary Artery Grafting
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Hospital Volume and Outcome after Bilateral Internal Mammary Artery Grafting. / Perrotti, Andrea; Reichart, Daniel; Gatti, Giuseppe; Faggian, Giuseppe; Onorati, Francesco; De Feo, Marisa; Chocron, Sidney; Dalén, Magnus; Santarpino, Giuseppe; Rubino, Antonino S; Maselli, Daniele; Gherli, Riccardo; Salsano, Antonio; Nicolini, Francesco; Zanobini, Marco; Bounader, Karl; Rosato, Stefano; Tauriainen, Tuomas; Juvonen, Tatu; Mariscalco, Giovanni; G Ruggieri, Vito; Biancari, Fausto.
In: HEART SURG FORUM, Vol. 23, No. 4, 08.07.2020, p. E475-E481.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Hospital Volume and Outcome after Bilateral Internal Mammary Artery Grafting
AU - Perrotti, Andrea
AU - Reichart, Daniel
AU - Gatti, Giuseppe
AU - Faggian, Giuseppe
AU - Onorati, Francesco
AU - De Feo, Marisa
AU - Chocron, Sidney
AU - Dalén, Magnus
AU - Santarpino, Giuseppe
AU - Rubino, Antonino S
AU - Maselli, Daniele
AU - Gherli, Riccardo
AU - Salsano, Antonio
AU - Nicolini, Francesco
AU - Zanobini, Marco
AU - Bounader, Karl
AU - Rosato, Stefano
AU - Tauriainen, Tuomas
AU - Juvonen, Tatu
AU - Mariscalco, Giovanni
AU - G Ruggieri, Vito
AU - Biancari, Fausto
PY - 2020/7/8
Y1 - 2020/7/8
N2 - BACKGROUND: Bilateral internal mammary artery (BIMA) grafting largely is underutilized in patients undergoing coronary artery bypass grafting (CABG), partly because of the perceived increased complexity of the procedure.AIMS: In this study, we evaluated whether BIMA grafting can safely be performed also in centers, where this revascularization strategy infrequently is adopted.METHODS: Out of 6,783 patients from the prospective multicenter E-CABG study, who underwent isolated non- emergent CABG from January 2015 to December 2016, 2,457 underwent BIMA grafting and their outcome was evaluated in this analysis.RESULTS: The mean number of BIMA grafting per center was 82 cases/year and hospitals were defined as high or low volume, according to this cutoff value. Six hospitals were considered as centers with a high volume of BIMA grafting (no. of procedures ranging from 120 to 267/year; overall: 2,156; prevalence: 62.2%) and nine hospitals as centers with a low volume of BIMA grafting (no. of procedures ranging from 2 to 39/year; overall: 301; prevalence: 9.1%). Multilevel mixed-effects regression analysis showed that the low- and high-volume cohorts had similar outcomes. Propensity score one-to-one matching analysis of 292 pairs showed that the low-volume cohort had a significantly shorter intensive care unit stay (2.2 ± 2.3 versus 2.9 ± 4.8 days, P = .020). The rates of in-hospital death (1.0% versus 0.3%, P = .625), deep sternal wound infection/mediastinitis (3.8% versus 3.1%, P = .824), and 1-year survival (98.1% versus 99.7%, P = .180) as well as other outcomes were similar between the high- and low-volume cohorts.CONCLUSIONS: BIMA grafting can be safely performed also in centers in which this revascularization strategy is infrequently performed.
AB - BACKGROUND: Bilateral internal mammary artery (BIMA) grafting largely is underutilized in patients undergoing coronary artery bypass grafting (CABG), partly because of the perceived increased complexity of the procedure.AIMS: In this study, we evaluated whether BIMA grafting can safely be performed also in centers, where this revascularization strategy infrequently is adopted.METHODS: Out of 6,783 patients from the prospective multicenter E-CABG study, who underwent isolated non- emergent CABG from January 2015 to December 2016, 2,457 underwent BIMA grafting and their outcome was evaluated in this analysis.RESULTS: The mean number of BIMA grafting per center was 82 cases/year and hospitals were defined as high or low volume, according to this cutoff value. Six hospitals were considered as centers with a high volume of BIMA grafting (no. of procedures ranging from 120 to 267/year; overall: 2,156; prevalence: 62.2%) and nine hospitals as centers with a low volume of BIMA grafting (no. of procedures ranging from 2 to 39/year; overall: 301; prevalence: 9.1%). Multilevel mixed-effects regression analysis showed that the low- and high-volume cohorts had similar outcomes. Propensity score one-to-one matching analysis of 292 pairs showed that the low-volume cohort had a significantly shorter intensive care unit stay (2.2 ± 2.3 versus 2.9 ± 4.8 days, P = .020). The rates of in-hospital death (1.0% versus 0.3%, P = .625), deep sternal wound infection/mediastinitis (3.8% versus 3.1%, P = .824), and 1-year survival (98.1% versus 99.7%, P = .180) as well as other outcomes were similar between the high- and low-volume cohorts.CONCLUSIONS: BIMA grafting can be safely performed also in centers in which this revascularization strategy is infrequently performed.
KW - Aged
KW - Coronary Artery Bypass/methods
KW - Coronary Artery Disease/surgery
KW - Female
KW - Follow-Up Studies
KW - Hospitals/supply & distribution
KW - Humans
KW - Male
KW - Mammary Arteries/transplantation
KW - Middle Aged
KW - Propensity Score
KW - Prospective Studies
KW - Risk Factors
U2 - 10.1532/hsf.2745
DO - 10.1532/hsf.2745
M3 - SCORING: Journal article
C2 - 32726226
VL - 23
SP - E475-E481
JO - HEART SURG FORUM
JF - HEART SURG FORUM
SN - 1098-3511
IS - 4
ER -
