Kress D C, Kroncke G M, Chopra P S, Cohen D J, Rasmussen P W, Nichols R D, Beatty E S, Berkoff H A
Division of Cardiothoracic Surgery, William S. Middleton Memorial Veterans Hospital, Madison, WI.
Arch Surg. 1988 Apr;123(4):439-43. doi: 10.1001/archsurg.1988.01400280045009.
Survival data were reviewed for 3330 open cardiac procedures from 1975 through 1984 at the William S. Middleton Memorial Veterans Hospital, Madison, Wis, and the University of Wisconsin Hospitals and Clinics, Madison. Respective operative survivals were 98.6% and 98.7% for myocardial revascularizations with vein graft or internal mammary artery (CABG), 96.2% and 96.8% for CABG reoperation, 97.8% and 95.9% for aortic valve replacement, 96.3% and 90.3% for aortic valve replacement plus CABG, 100.0% and 94.9% for mitral valve replacement, and 100.0% and 82.9% for mitral valve replacement plus CABG. There were no significant differences in six-year survival curves between hospitals despite threefold differences in average annual caseload (88 vs 294). This suggest that residency-directed cardiac surgery programs can function equally as well at a Veterans Administration hospital as at an affiliated university hospital.
回顾了1975年至1984年期间在威斯康星州麦迪逊市的威廉·S·米德尔顿纪念退伍军人医院以及麦迪逊市的威斯康星大学医院及诊所进行的3330例心脏直视手术的生存数据。采用静脉移植或乳内动脉进行心肌血运重建术（冠状动脉搭桥术，CABG）的手术生存率分别为98.6%和98.7%，冠状动脉搭桥术再次手术的生存率分别为96.2%和96.8%，主动脉瓣置换术的生存率分别为97.8%和95.9%，主动脉瓣置换术加冠状动脉搭桥术的生存率分别为96.3%和90.3%，二尖瓣置换术的生存率分别为100.0%和94.9%，二尖瓣置换术加冠状动脉搭桥术的生存率分别为100.0%和82.9%。尽管两所医院的年均病例数相差三倍（88例对294例），但六年生存曲线并无显著差异。这表明由住院医师主导的心脏外科手术项目在退伍军人管理局医院的运作效果与在附属大学医院的效果相当。
