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2018 European Guidelines Suggest Undergoing CABG in Centers That Perform at Least 200 CABG Cases per Year

By Susan Eymann, MS24 Feb 2020

In recognition of February as American Heart Awareness month, Transonic is pleased to share this blog heart blog along with an offer for a free Transonic Flowprobe. To learn more about the offer, click here.

The 2018 European Guidelines for Myocardial Revascularization suggest that patients should take note of the number of coronary artery bypass grafting (CABG) surgeries performed by a medical center before undergoing CABG at a particular center. The Guidelines point to studies that suggest that the volume of CABG surgeries performed in a hospital significantly impacts outcomes including in-hospital mortality.1,2

“An increase in mortality observed in lower volume centers seems to be attributable Screen Shot 2020-02-07 at 11.39.30 AM

to so-called `failure to rescue’: although patients operated on at low-volume centers are not at particularly higher risk of suffering a major complication, they are more likely to die from such a complication should it occur.” 3

The Guidelines state: “consideration should be given to the performance of CABG in centers with an annual volume of at least 200 CABG cases.”

The Guidelines also note that, “Apart from hospital volume, higher surgeon volume also appears to be inversely related to operative mortality.” One 2003 study published in the New England Journal of Medicine provided evidence that suggested that the experience of both hospitals and surgeons impact outcomes.

1. Post PN, Kuijpers M, Ebels T, Zijlstra F, “The relation between volume and outcome of coronary interventions: a systematic review and meta-analysis,” Eur Heart J. 2010;31:1985-1992.
2. Kim LK, Looser P, Feldman DN, “Peri- and postoperative care after coronary artery bypass grafting in low versus high volume centers,” J Thorac Cardiovasc Surg. 2016;152:1205.
3. Gonzalez AA, Dimick JB, Birkmeyer JD, Ghaferi AA, “Understanding the volume-outcome effect in cardiovascular surgery:The role of failure to rescue,” JAMA Surg. 2014;149:119-123.
4. BirkmeyerBirkmeyer JD, Stukel TA, Siewers AE, Goodney PP, Wennberg DE, Lucas FL, “Surgeon volume and operative mortality in the United States,” N Engl J Med. 2003;349:2117-2127

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