Clinical Outcomes of the Establishment of Cardiac Surgery Service Adjacent to an Existing Standalone Interventional Cardiology Service at the Same Medical Center

Introduction: Patients with left main (LM) or triple vessels coronary artery disease (TVCAD), treated in medical centers without cardiac surgery service, may not receive the optimal revascularization treatment. The objective of this study was to compare the effects of the establishment of a cardiac surgery service adjacent to an existing standalone interventional cardiology service at the same medical center on clinical outcomes.

Materials and Methods: A total of 1633 patients diagnosed with LM or TVCAD referred to either coronary artery bypass graft (CABG) or percutaneous coronary intervention (PCI) were included in the study. Post-operative outcomes including mortality, acute myocardial infarction (AMI) and re-hospitalizations were compared before and after the establishment of a cardiac surgery service adjacent to a standalone cardiology service.

Results: 495 patients underwent PCI before the establishment of a cardiac surgery service (Group A). 831 patients underwent PCI (Group B) and 307 underwent CABG (Group C) after the cardiac surgery service establishment respectively. Patients who have undergone PCI before the establishment of cardiac surgery service had a significantly higher rate of re-hospitalizations, AMI and mortality rate compared with patients who have undergone either PCI or CABG after its establishment (Figure 1A, 1B, 1C).

Conclusion: Establishment of a cardiac surgery service adjacent to a standalone invasive cardiology service at the same medical center may optimize revascularization treatment for patients with LM or TVCAD, and may reduce post procedure AMI, re-hospitalizations and mortality rates.