Our team of surgeons, along with nurses and support staff, are the most experienced team in the area and administer an extraordinary level of expertise and personalized care.
Compare Akron General with National Standards:
Coronary Artery Bypass Graft (CABG)
Hospital Surgical Volume
Physician Board Certification
Average Length of Stay
Advanced Techniques or Interventions
Internal Mammary Artery Graft
Aspirin at Discharge
Post-Operative Infection
Inpatient Mortality Rate
Smoking Cessation
1. Hospital Surgical Volume
Surgical or procedure volume tells the number of cases performed per year by a surgeon, or at a particular facility. Surgical volume may be used to denote clinical expertise. Numerous studies demonstrate that higher volume of a particular procedure, such as CABG, is significantly linked to better outcomes, according to The Leapfrog Group.
The Leapfrog Group recommends 450 CABG procedures per year as the minimum volume standard in order to achieve better surgical outcomes (Annals of Surgery, October 2003: 238(4); 447-457). However, other studies have shown that high volume is not the only important measure of quality. In fact, some hospitals may have a lower volume and still have excellent outcomes (JAMA, January 14, 2004: 291(2); 195-201).
Akron General Medical Center performed 489 coronary artery bypass procedures in 2006.
2. Physician Board Certification
A board-certified physician has completed an approved educational training program and an evaluation process including an examination designed to assess the knowledge, skills, and experience necessary to provide quality patient care in that specialty. A specialty certificate is issued by a medical specialty certifying board, which is valid nationwide. Although certification is not required for an individual physician to practice medicine, most hospitals and managed care organizations require that at least a certain percentage of their staff be “board certified." ABMS Member Boards. (American Board of Medical Specialties)
All of Akron General Medical Center’s cardiothoracic surgeons are board certified in Thoracic Surgery by the American Board of Thoracic Surgery.
3. Average Length of Stay
The average length of stay (measured in days) provides general information about the efficiency of care delivery, and is therefore an important quality indicator. However, patients with a greater severity of illness may have a longer average length of stay.
According to the most recent national data from the Society of Thoracic Surgeons'™(STS) National Database, the average post-procedure length of stay for isolated coronary artery bypass graft (CABG) procedures in 2005 was 7.5 days (STS National Database).
NOTE: "Isolated CABG" means that no other cardiac surgical procedures, such as valve repair or replacement, were performed during the procedure.
In 2006, Akron General Medical Center's average length of stay for isolated CABG was 8.8 days, which was better than the average length of stay for isolated CABG procedures in 2005 in the Society of Thoracic Surgeons' National Database.
4. Advanced Techniques or Interventions
In the past decade, improvements in techniques, practices, and processes, have contributed to improved outcomes. (Annals of Surgery, January 2004: 239(1): 110-17)
Akron General Medical Center offers newer techniques for coronary artery bypass procedures when appropriate, including off-pump CABG, minimally-invasive CABG, endoscopic procedures, transmyocardial laser revascularization (TMR) and a modified maze procedure.
5. Internal Mammary Artery Graft
Veins or arteries may be used to bypass obstructed coronary arteries. A piece, or section, of a vein is usually taken from one or both legs. An artery in the chest, the internal mammary artery (IMA), may also be used. A section of other arteries may sometimes be used, such as the radial artery near the wrist.
Use of the internal mammary artery (IMA) to bypass the left anterior descending (LAD) coronary artery has been considered the “gold standard” since 1985. New England Journal of Medicine, January 2, 1986: 314 (1); 1-6) The National Quality Forum (NQF) includes the use of internal mammary artery grafts as a standard in its National Voluntary Consensus Standards for Hospital Care: An Initial Performance Measure Set, published in 2003.
The routine use of the left internal mammary artery (LIMA) for bypassing the left anterior descending (LAD) coronary artery (one of the main coronary arteries) with supplemental saphenous vein grafts (taken from a leg vein) to other coronary artery lesions (obstructions) is generally accepted as the standard grafting method (Circulation, August 31, 2004: 110(9); 1168-1176).
More recently, it has been established that the IMA may be safely used in more situations than previously thought, such as during emergency operations, in elderly patients, and in the presence of certain conditions such as severe left ventricular dysfunction (poor pumping ability of the left ventricle), chronic obstructive pulmonary disease with enlarged lungs, and an obstructed left subclavian artery (located under the collarbone) (Circulation, January 2001: 103(4); 507-512).
Internal mammary artery grafts were used, when indicated, in 89% of all CABG procedures performed in 2006 at Akron General Medical Center.
6. Aspirin at Discharge
Aspirin significantly reduces vein graft closure during the first postoperative year. (Circulation, September 28, 1999: 100(13); 1464-1480). Individuals who are at increased risk for bleeding, however, may not be candidates for aspirin therapy because aspirin thins the blood, further increasing the risk of bleeding.
91 percent of coronary artery bypass graft (CABG) patients who receive vein grafts at Akron General Medical Center have aspirin prescribed at discharge.
7. Post-Operative Infection
There are several ways to reduce the risk of wound infections in patients undergoing coronary artery bypass graft (CABG). Antibiotic administration before surgery greatly reduces the risk of postoperative infection. Therapy should be administered just prior to the incision and again in the operating room if the operation exceeds 3 hours. Many centers closely monitor antibiotic timing in an effort to reduce the risk of surgical infection (Circulation. August 31, 2004; 110: 1168-1176).
The rate of post-operative infections for CABG at Akron General Medical Center in 2006 was 0.8%.
8. Inpatient Mortality Rate
The mortality rate (measured as a percentage) provides general information about the quality of care delivery, and can be an important quality indicator. However, some hospitals care for patients with a greater severity of illness and therefore may have a higher mortality rate.
According to the most recent national data available from the Healthcare Cost and Utilization Project's (HCUP) Nationwide Inpatient Sample from the Agency for Healthcare Research and Quality (AHRQ), the inpatient mortality rate for CABG was 2.2 percent.
Akron General Medical Center's inpatient mortality rate for CABG was 1.9% in 2006.
9. Smoking cessation
Smoking is a modifiable risk factor for heart disease. National guidelines strongly recommend smoking counseling to help people to quit smoking (National Cancer Institute (NCI) Prevention and Cessation of Cigarette Smoking: Control of Tobacco Use). Tobacco Cessation Guidelines from the United States Department of Health and Human Services (DHS) provide helpful tips on smoking cessation for patients.
At Akron General Medical Center, in 2006, 100% of eligible persons undergoing CABG received referrals for smoking cessation counseling through a cardiac rehab program.
