Antoniou Athanasios, Bashir Mohamad, Harky Amer, Adams Benjamin, Uppal Rakesh
Department of Cardiac Surgery, Barts Heart Centre, St Bartholomew's Hospital, West Smithfield, London, EC1A 7BE, UK.
Gen Thorac Cardiovasc Surg. 2019 Jan;67(1):32-36. doi: 10.1007/s11748-018-0939-5. Epub 2018 May 12.
Over the past few decades, the advents in monitoring, imaging, diagnostics, and implementation of multidisciplinary team approach in Type A aortic dissection surgery resulted in improved surgical outcomes. One other factor that needed to be targeted and carefully analyzed was the volume-outcome relationship on hospital and surgeon level in the settings of Type A dissection. This surely sprung form reports which indicated that supercenters providing aortic services with concentrated expert and expertise were performing better than smaller centers. We dwell in this article on the body of evidence to support concentration of experts and the effect of this organization on volume, referral, and outcome in Type A aortic dissection.
在过去几十年里，A型主动脉夹层手术在监测、成像、诊断以及多学科团队方法的实施方面取得的进展，使得手术结果得到了改善。另一个需要关注并仔细分析的因素是A型夹层情况下医院和外科医生层面的手术量-结果关系。这无疑源于一些报告，这些报告表明，拥有集中的专家和专业技能提供主动脉服务的超级中心，其表现优于较小的中心。在本文中，我们详述支持专家集中的证据主体，以及这种组织形式对A型主动脉夹层的手术量、转诊和结果的影响。
