[Surgical therapy of coronary artery disease in the Italian cardiac surgery centers].
BACKGROUND
We conducted a national survey on surgical therapy for coronary artery disease and its complications, with the aim to eventually identify differences in the processes of care adopted in the Italian cardiac surgery centers.


METHODS
Eighty-seven Italian cardiac surgery units received a questionnaire about their general activity profile and the following interest areas: (a) surgical myocardial revascularization techniques; (b) ischemic mitral regurgitation treatment; (c) left ventricular reconstruction procedures; (d) mechanical circulatory support and heart transplantation in ischemic cardiomyopathy.


RESULTS
Forty-one Centers (47.1%) returned a completely filled questionnaire. The analysis of the answers showed differences in the therapeutic approaches adopted in the various centers regarding: choice of surgical technique and grafts for myocardial revascularization; propensity to treat moderate ischemic mitral regurgitation in the setting of severe left ventricular dysfunction; propensity to treat extended myocardial scars; treatment options in ischemic cardiomyopathy with advanced heart failure. The specific center profile (volume of activity, availability of heart transplantation) seems to influence the choice among the different treatment options.


CONCLUSIONS
This study may contribute to show and analyze existing differences in clinical practice between different centers. Diagnostic and therapeutic approaches (processes of care) should be frequently monitored in order to promptly single out critical areas necessitating review or further researches, to standardize decision making criteria, and to improve care appropriateness.
Fundarò
Pino
P
Divisione di Cardiochirurgia, Dipartimento Cardiologico A. De Gasperis, Ospedale Niguarda Ca'Granda, Milano. pinofundaro@yahoo.it
Tartara
Paolo
P
Villa
Emmanuel
E
Trunfio
Salvatore
S
Campisi
Salvatore
S
Pelenghi
Stefano
S
Tarelli
Giuseppe
G
Vitali
Ettore
E
D000368:Aged; D000369:Aged, 80 and over; D006348:Cardiac Surgical Procedures / Q000706:statistics & numerical data*; D006801:Humans; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000601:surgery*; D011795:Surveys and Questionnaires