Improved outcomes in coronary artery bypass grafting with beating-heart techniques Michael Mack, MD, Donna Bachand, RN, PhD, Tea Acuff, MD, James Edgerton,

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Presentation transcript:

Improved outcomes in coronary artery bypass grafting with beating-heart techniques Michael Mack, MD, Donna Bachand, RN, PhD, Tea Acuff, MD, James Edgerton, MD, Syma Prince, RN, Todd Dewey, MD, Mitchell Magee, MD The Journal of Thoracic and Cardiovascular Surgery Volume 124, Issue 3, Pages 598-607 (September 2002) DOI: 10.1067/mtc.2002.124884 Copyright © 2002 American Association for Thoracic Surgery Terms and Conditions

CRSTI Research Staff The Journal of Thoracic and Cardiovascular Surgery 2002 124, 598-607DOI: (10.1067/mtc.2002.124884) Copyright © 2002 American Association for Thoracic Surgery Terms and Conditions

Fig. 1 Adoption rate of beating-heart surgery. Shaded area represents percentages of all isolated CABG procedures performed off-pump from 1995 through 2000. The Journal of Thoracic and Cardiovascular Surgery 2002 124, 598-607DOI: (10.1067/mtc.2002.124884) Copyright © 2002 American Association for Thoracic Surgery Terms and Conditions

Fig. 2 Percentages of beating-heart procedures performed as single-vessel (MIDCAB) rather than multivessel bypass. The Journal of Thoracic and Cardiovascular Surgery 2002 124, 598-607DOI: (10.1067/mtc.2002.124884) Copyright © 2002 American Association for Thoracic Surgery Terms and Conditions

Fig. 3 Trends in observed mortality for off-pump (heavy rule) and on-pump (light rule) groups from 1995 through 2000. The Journal of Thoracic and Cardiovascular Surgery 2002 124, 598-607DOI: (10.1067/mtc.2002.124884) Copyright © 2002 American Association for Thoracic Surgery Terms and Conditions

Fig. 4 Trends in predicted risk according to STS risk algorithm for off-pump (heavy rule) and on-pump (light rule) groups from 1996 through 2000. Series P =.004; 1999 P =.023; P not significant in other years. The Journal of Thoracic and Cardiovascular Surgery 2002 124, 598-607DOI: (10.1067/mtc.2002.124884) Copyright © 2002 American Association for Thoracic Surgery Terms and Conditions

Fig. 5 Trends in risk adjusted mortality for off-pump (heavy rule) and on-pump (light rule) groups from 1996 through 2000. P <.01 for all years. The Journal of Thoracic and Cardiovascular Surgery 2002 124, 598-607DOI: (10.1067/mtc.2002.124884) Copyright © 2002 American Association for Thoracic Surgery Terms and Conditions

Fig. 6 CABG-associated mortalities among patients of high adopters (light rule) and low adopters (heavy rule) of beating-heart surgery from 1990 through 2000. The Journal of Thoracic and Cardiovascular Surgery 2002 124, 598-607DOI: (10.1067/mtc.2002.124884) Copyright © 2002 American Association for Thoracic Surgery Terms and Conditions

Fig. 7 Adoption rates of beating-heart surgery among 3 surgeons with highest mortality (light rule) and 3 surgeons with lowest mortality (heavy rule) from 1995 through 2000. The Journal of Thoracic and Cardiovascular Surgery 2002 124, 598-607DOI: (10.1067/mtc.2002.124884) Copyright © 2002 American Association for Thoracic Surgery Terms and Conditions

Fig. 8 Annual trend in observed operative mortality from 1990 through 2000. Arrow indicates introduction of beating-heart surgery. The Journal of Thoracic and Cardiovascular Surgery 2002 124, 598-607DOI: (10.1067/mtc.2002.124884) Copyright © 2002 American Association for Thoracic Surgery Terms and Conditions