Logo

American Heart Association

  2
  0


Final ID: Mo4186

Multiple Arterial Graft Use: Sustained Quality Improvement Following a Targeted Assessment and Programmatic Intervention

Abstract Body (Do not enter title and authors here): Introduction/Background:
Multiple arterial grafting (MAG) provides superior outcomes compared to single arterial grafting in coronary artery bypass graft (CABG) patients. Studies and meta-analyses demonstrate MAG's association with improved survival, reduced major adverse cardiac events, and lower repeat revascularization rates. Despite strong evidence and guidelines, MAG utilization remains low nationally, ranging from 4-11%. Surgeons cite concerns such as advanced age, diabetes, and high body mass index (BMI) for not employing MAG. An educational and quality improvement initiative raised MAG usage from 11% to over 30% at one academic institution. This study reassesses MAG adoption trends and barriers three years later at the same institution.
Research Question/Hypothesis:
We investigated whether the increased adoption of MAG after a quality improvement initiative was sustained three years later. We hypothesized that MAG utilization would remain elevated due to the lasting impact of initial educational efforts, though some barriers might persist.
Methods/Approach:
We assessed MAG utilization and surgeons' reasons for not using MAG in isolated CABG procedures with two or more grafts over a four-month period. This evaluation aimed to determine if the previous quality improvement initiative's adoption of MAG was sustained post-implementation. The study analyzed MAG use frequency and surgeons' justifications for alternative methods, including patient outcomes, surgeon preferences, and institutional practices.
Results:
A total of 92 patients were included, with MAG used in 28 cases (30.4%). The MAG use rate three years earlier following the quality initiative was 30.5%. Predominant reasons for not using MAG were age > 65 (29.9%), diabetes (18.8%), BMI ≥35 (14.1%), and non-critical disease (9.4%), similar to concerns from three years prior: age >75 (30.8%), diabetes (23.1%), and BMI > 35 (22.9%) (Figure 1).
Conclusions:
The sustained adoption rate of MAG among cardiac surgeons at one institution highlights the complexities of changing surgical practices, even with targeted educational efforts. Continuous support and educational initiatives led by surgeon-champions are crucial for enhancing long-term adoption of evidence-based practices like MAG, ultimately improving patient care. Dedicated mentoring and regular training updates significantly influence the integration of advanced surgical techniques into routine practice, advancing patient treatment quality.
  • Chinedozi, Ifeanyi  ( Johns Hopkins University , Baltimore , Maryland , United States )
  • Lawton, Jennifer  ( Johns Hopkins , Owings Mills , Maryland , United States )
  • Daskam, Maria  ( Johns Hopkins University , Baltimore , Maryland , United States )
  • Briscoe, Jessica  ( Johns Hopkins University , Baltimore , Maryland , United States )
  • Kumar, Nivedita  ( Johns Hopkins University , Baltimore , Maryland , United States )
  • Darby, Zachary  ( Johns Hopkins University , Baltimore , Maryland , United States )
  • Sangalang, Janelle  ( Johns Hopkins University , Baltimore , Maryland , United States )
  • Kang, Jin Kook  ( Johns Hopkins University , Baltimore , Maryland , United States )
  • Kpuska, Vesa  ( Johns Hopkins University , Baltimore , Maryland , United States )
  • Behrens, Kim  ( Johns Hopkins Hospital , Baltimore , Maryland , United States )
  • Author Disclosures:
    Ifeanyi Chinedozi: DO NOT have relevant financial relationships | Jennifer Lawton: DO NOT have relevant financial relationships | Maria Daskam: DO NOT have relevant financial relationships | Jessica Briscoe: No Answer | Nivedita Kumar: DO NOT have relevant financial relationships | Zachary Darby: DO NOT have relevant financial relationships | Janelle Sangalang: DO NOT have relevant financial relationships | Jin Kook Kang: DO NOT have relevant financial relationships | Vesa Kpuska: DO NOT have relevant financial relationships | Kim Behrens: No Answer
Meeting Info:

Scientific Sessions 2024

2024

Chicago, Illinois

Session Info:

Innovations and Outcomes in Coronary Artery Bypass Grafting: Techniques and Interventions

Monday, 11/18/2024 , 10:30AM - 11:30AM

Abstract Poster Session

More abstracts on this topic:
A Case of Dilated Cardiomyopathy and Systemic Thromboembolism in a Young Patient on Testosterone Replacement Therapy

Sabri Muhammad, Ijaz Naila, Nadeem Ramsha, Checchio Lucy, Riaz Faiza

Accumulation of Epicardial Adipose Tissue as a Marker of Diastolic Dysfunction in Patients With Preserved Left Ventricular Ejection Fraction Undergoing Coronary Computed Tomography Angiograph

Ishikawa Hirotoshi, Kasayuki Noriaki, Fukuda Daiju, Otsuka Kenichiro, Sugiyama Takatoshi, Yamaura Hiroki, Hojo Kana, Kawa Yoshinori, Shintani Ako, Ito Asahiro, Yamazaki Takanori

More abstracts from these authors:
Radial Artery Pseudoaneurysm Following Transradial Cardiac Catheterization: A Systematic Review and Case Report

Chinedozi Ifeanyi, Lawton Jennifer, Sulague Ralf Martz, Athipathy Nikhita, Kumar Nivedita, Le Anson, Juboori Hiba, Darby Zachary, Kang Jin Kook, Kilic Ahmet

Sequential Radial Artery Grafting Safely and Efficiently Increases Multi Arterial Grafting in Patients Undergoing Coronary Artery Bypass Grafting: A Propensity Score Analysis of Operative Outcomes

Chinedozi Ifeanyi, Kachroo Puja, Lawton Jennifer, Mathews Jonathan, Lee Anson, Larson Emily, Sangalang Janelle, Kumar Nivedita, Wang Hanghang, Kang Jin Kook, Darby Zachary

You have to be authorized to contact abstract author. Please, Login
Not Available