JACC: CABG procedures align with guidelines

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The vast majority of CABG procedures are performed appropriately and in accordance with the 2004 ACC/AHA guidelines for CABG surgery, according to a regional study published in the June 17 issue of the Journal of the American College of Cardiology.

Gerald T. O'Connor, PhD, ScD, from the Dartmouth-Hitchcock Medical Center in Lebanon, N.H., and colleagues said the goal of their study was to assess the concordance between the American College of Cardiology (ACC) and the American Heart Association (AHA) 2004 Guideline Update for CABG Surgery and actual clinical practice.

The researchers evaluated nearly 4,700 consecutive isolated CABG procedures performed in 2004 and 2005 in northern New England. They found that 98.6 percent of procedures were considered appropriate.

The authors found no obvious or statistically significant difference in the appropriateness of cardiac surgery of men and women.

Among those 1.4 percent of procedures that were considered inappropriate, the authors noted that 66 percent of those patients had poor left ventricular function. CABG surgery in these patients should be conditional on establishing the ischemic origin of the cardiomyopathy and the presence of sufficient viable myocardium for successful revascularization to improve pump function, according to the researchers.

As a result of their findings, O’Connor and colleagues concluded that “the routine use of the guidelines benefits the patient, the physician and the hospital.”