Evidence-based Awards for Cardiac Care
Blue Shield of California has designated Stanford Hospital & Clinics as a Blue Distinction Center for Cardiac Care, a distinction by BlueCross and BlueShield companies signifying that our hospital has demonstrated our commitment to quality care, resulting in better overall outcomes for cardiac patients. Stanford Hospital & Clinics meets evidence-based clinical criteria, developed by the Blue Cross Blue Shield Association in collaboration with expert physicians’ and medical organizations, including the American College of Cardiology and the Society of Thoracic Surgeons, and is subject to periodic re-evaluation as criteria continue to evolve.
Additionally, the Society of Thoracic Surgeons (STS) has recently developed a comprehensive rating system that allows for 
comparisons regarding the quality of cardiac surgery among hospitals across the country. Approximately 14% of hospitals receive the “3 star” rating, which denotes the highest category of quality. In the current analysis of national data covering the period from January to December 2008, the cardiac surgery performance of our hospital was found to lie in the highest quality tier, thereby receiving an STS 3 star rating.
United Healthcare has also awarded Stanford Medical Center with the UnitedHealth Premium Cardiac Specialty Center “Three Stars” and “Higher Efficiency” designations, signifying that our facilities offer quantifiable quality and cost-effective cardiac procedures and cardiac care services. Participation in this program is voluntary, and to be considered for this designation, hospitals must complete a survey and submit outcomes data to the American College of Cardiology and/or the Society of Thoracic Surgeons. Surveys are evaluated on an ongoing basis, and the current designation period began in September 2007 and runs through September 2009.
View the Reports
The reports presented below compare the outcomes of various procedures performed at Stanford Hospital & Clinics (SHC) to that of the national averages as reported by the STS. Unless noted otherwise, this data is risk adjusted, meaning it takes into account a specific hospital’s and national patient’s preoperative risk factors and co-morbidities and then compares outcomes between the hospital’s and the national average performance. This risk-adjustment method levels the playing field for a valid comparison between hospitals regardless of the severity of the patients they treat.
The outcomes listed below represent only some of the cardiovascular services offered at Stanford. For those procedures not listed, you may download the comprehensive, 40-page report.
- Risk-Adjusted Operative Mortality Rate %: Coronary Artery Bypass Graft (CABG), Valve, and Valve+CABG Combined
- Isolated Coronary Artery Bypass Graft Risk-Adjusted Operative Mortality Rate %
- Internal Mammary Artery & Radial Artery Graft Use with Isolated Coronary Artery Bypass Graft
- Isolated Aortic Valve Replacement Risk-Adjusted Operative Mortality Rate %
- Combined Isolated Mitral Valve Replacement or Mitral Valve Repair Observed Operative Mortality Rate
- Aortic Root Surgery: Composite Valve Graft Aortic Valve and Root Replacement & Tirone David Aortic Valve-Sparing Root Replacement Case Volumes
Major Procedures
Risk-Adjusted Operative Mortality Rate (RAMR) %
Coronary Artery Bypass Graft (CABG), Valve, and Valve+CABG Procedures Combined
This report reflects the mortality rate for this group of the most commonly performed cardiac procedures for the average national patient coming to Stanford Hospitals & Clinics (SHC) for an operation. Patients coming to Stanford Hospital & Clinics consistently have a decreased chance of mortality as compared to the average national hospital.
Isolated Coronary Artery Bypass Graft (CABG)
Risk-Adjusted Operative Mortality Rate (RAMR) %
"Isolated Coronary Artery Bypass Graft" means that no other operative procedures were performed other than a coronary artery bypass graft. Again, Stanford Hospital & Clinics (SHC) has consistently better mortality outcomes than the average national hospital.
Internal Mammary Artery & Radial Artery Graft Use with Isolated Coronary Artery Bypass Graft (CABG)
Use of internal mammary artery grafts is an established national quality measure in coronary artery bypass graft (CABG) surgery. Internal mammary arterial grafts provide better blood flow for a longer length of time. Radial arterial grafts have also been shown to provide blood flow for longer periods of time. Stanford surgeons will utilize arterial grafts whenever possible. Stanford Hospital & Clinics (SHC) consistently has a higher percentage of internal mammary artery graft usage and radial artery graft usage than the average national hospital.
Isolated Aortic Valve Replacement
Risk-Adjusted Operative Mortality Rate (RAMR) %
This isolated aortic valve replacement outcomes data includes replacement with both mechanical and bioprosthetic valves where no other procedure is performed. Surgeons at Stanford Hospital & Clinics (SHC) will discuss with each patient the pros and cons of each valve type in relation to their individual aortic valve pathology. The patient is part of the decision-making process in choosing the replacement valve that will provide the best outcomes as well as suit their lifestyles.
Combined Isolated Mitral Valve Replacement
and Mitral Valve Repair Observed Operative Mortality Rate
This is actual (observed) mortality rate comparison for a combination of the two types of mitral valve procedures: mitral valve repair and mitral valve replacement. Mitral valve repair is associated with better patient outcomes, and Stanford will repair the mitral valve unless replacement is absolutely necessary. In 2008, 68% of Stanford’s isolated mitral valve procedures were repairs compared to 55% nationally. Stanford has dedicated research laboratories continually evaluating the best methods and equipment for mitral valve surgery.
Aortic Root Surgery: Composite Valve Graft (CVG) Aortic Valve and Root Replacement & Tirone David Aortic Valve-Sparing Root Replacement Case Volumes
A Tirone David V with Stanford modification valve-sparing aortic root replacement (VSARR) operation utilizes the native aortic valve so the patient doesn't need life-long anti-coagulation therapy. This is a great benefit to patients with Marfan Syndrome or a bicuspid aortic valve, particularly the young and middle-aged. A composite valve graft (CVG) procedure combines either a mechanical or bioprosthetic valve built into the replacement section of the aortic root. Stanford's surgeons thoroughly evaluate each individual patient's pathology and lifestyle and allow each individual to help choose the best surgical procedure for the best long-term outcome. Stanford's thoracic aortic surgical team has performed more Tirone David procedures than any other hospital in the western United States. Stanford University's Center for Marfan Syndrome and Related Aortic Disorders is used as a model around the world.
The actual operative mortality rate for elective and urgent CVG procedures from 2005 to 2008 is 2.1%. Although there is no Society of Thoracic Surgery (STS) benchmark regarding mortality rates for complex CVG aortic root replacement procedures, this 2.1% mortality rate can be compared to the 2008 STS national mortality rate for a basic isolated aortic valve replacement (3.1%) to better understand the experience and expertise provided at Stanford for complex heart surgery.
Stanford's long history of performing and improving upon VSARR operations is reflected in our mortality outcomes. In our fourteen-year history of performing this procedure (electively or urgently), the mortality rate is less than 1%, with no operative mortality within the last four years. A comparison with the 2008 STS national mortality rate of 3.1% for basic isolated aortic valve replacement highlights our ability to perform complex aortic procedures with lower risk than other centers perform less complex procedures.
Back to top »The Division of Thoracic Surgery in the Department of Cardiothoracic Surgery at the Stanford School of Medicine is located in the San Francisco Bay Area in northern California. For more information about our services, please contact Donna Minagawa at (650) 721-2086 or Angela Lee, RN, MS, at (650) 721-5402.
