Cardiovascular Diseases and Cardiac Surgery

Overview

Juan A. Crestanello, M.D., is a cardiovascular surgeon and department chair of Cardiovascular Surgery at Mayo Clinic in Rochester, Minnesota. Dr. Crestanello, who specializes in surgery for valvular heart disease, discusses the impact of hospital volume on outcomes of septal myectomy for hypertrophic cardiomyopathy.

JUAN CRESTANELLO: Welcome to the Cardiovascular Surgery Series where I review the latest research in cardiovascular surgery from the Mayo Clinic in just two minutes. I am Dr. Juan Crestanello.

Researchers from the Mayo Clinic investigated the association between hospital volumes and outcomes in patients having septal myectomy for hypertrophic cardiomyopathy. The investigators used the STS database to identify 5,935 patients who had septal myectomy between 2012 and 2019.

Operations were performed in 581 centers by 933 surgeons. Seventy-five percent of the centers performed less than one case per year. Only 2% of the centers performed more than 10 cases per year, and they accounted for 46% of the patients.

Early outcomes examined were mortality, VSD, heart block, and mitral valve surgery. Mortality, VSD, permanent pacemaker, and mitral valve surgery decrease with center experience. By multivariate analysis, case volume greater than 10 improved outcomes.

The investigators conclude that a minimum case volume of 10 cases per year is necessary to achieve optimal outcomes. Thank you for listening to the Cardiovascular Surgery Series.