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State Report Cards

Open-Heart Surgery, Angioplasty and Heart Attack

There is no standard way that states make outcomes reports available to consumers and only four states report their heart surgery outcomes data to the public. States that make this critical information available historically see a decline in mortality rates, and that's great news for consumers! Be careful when evaluating this data as by the time it is gathered, sorted, risk-stratified and posted, it is at least three years old. The information is useful for discussion with your primary care practitioner and insurer to help guide you to make the best care decision, based on your particular needs and individual risk.

Consumer Reports provides a list of links rating hospitals on a variety of health conditions. Click here for Consumer Reports on Health.

Links to States' Cardiac Surgery Report Cards


About 68 million Americans have some form of heart-related disease. It is the leading cause of death in the United States. Atherosclerotic coronary artery disease occurs when the arteries that supply blood to the heart muscle become lined with fatty deposits that harden and become partially blocked. The amount of blood reaching the heart is reduced. The reduced flow of blood can cause chest pain (angina), or a heart attack. Heart disease is, by far, the leading cause of death in the U.S. and atherosclerotic coronary artery disease is the most common form of heart disease.

Different treatments are recommended for different patients. For some, changes in lifestyle (dietary changes, not smoking, regular exercise) can result in great improvements in health. For others, medication is prescribed -- to treat high blood pressure or some other conditions. Sometimes with coronary artery disease, surgery is advised.

Cardiac catheterization is a diagnostic tool used to definitively diagnosis the extent of blockages in the coronary arteries and to determine whether or not surgery is needed. A long, thin tube, called a catheter, is inserted into a blood vessel in the groin and threaded into the coronary arteries. Dye is injected through the catheter and X-rays of the vessels are then taken.

If surgery is advised, the two common procedures performed on patients with coronary artery disease are coronary artery bypass graft (CABG) surgery and percutaneous transluminal coronary angioplasty (PTCA).

Coronary artery bypass graft srugery is a procedure in which a vein or artery from another part of the body is used to create an alternate path for blood to flow to the heart, bypassing the arterial blockage. Typically, a section of one of the large (saphenous) veins in the leg, the radial artery in the arm or the mammary artery in the chest is used to construct the bypass. One or more bypasses may be performed during a single operation, since providing several routes for the blood supply to travel is believed to improve long-term success for the procedure. Triple and quadruple bypasses are often done for this reason, not necessarily because the patient's condition is more severe. CABG surgery is one of the most common successful major operations currently performed in the United States. In 1999, approximately 700,000 procedures were performed in the U.S. alone.

Many factors can influence the outcome of coronary artery bypass surgery. These include the patient's health before the procedure, the patient feeling supported and in control of the decision-making, general after care, and most important - the skill of the operating team. Practice makes perfect and a surgeon who operates on 300 patients a year has much more experience and skill than a surgeon who only performs 100 or less operations a year. Additional considerations are "on-pump" versus "off-pump". On-pump refers to use of the heart bypass machine, which poses an independent risk to the patient (i.e. kidney function impairment, ischemia (reduced blood flow) to the brain with resultant memory impairment and generalized swelling, just to name a few) however, operating on a beating heart requires a great deal more surgical skill. More and more surgeons are aquiring this skill in response to consumer demand. The trend is also for less invasive procedures with angioplasty leading the way in new advancements.

State reports on heart surgery outcomes are referred to as “Report Cards“. On-line Report Cards are intended for patients, families of patients who are considering coronary artery bypass surgery and health care providers. It provides data on risk factors associated with bypass surgery mortality and lists hospital and physician-specific mortality rates which have been adjusted to account for differences in patient severity of illness, and other risks (e.g. older age and being of female gender).

Related links:

Bloodless Care Options
Questions to Ask Before You Have Heart Surgery (pdf format)



State Report Cards   |  Questons Before Heart Surgery  |  Heart Surgery Options  |  Scarless Heart Surgery  |  Valve Surgery Options   |  Bloodless Care: What You Need to Know  |  Being Informed About Your Medical Care

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1999-2000; updates: 2002, 2004, 2005, 2007 Women's Heart Foundation, Inc. All rights reserved. Unauthorized use prohibited. The information contained in this Women's Heart Foundation (WHF) Web site is not a substitute for medical advice or treatment, and WHF recommends consultation with your doctor or health care professional.