Risk of aortocoronary bypass surgery in a low-volume inner city hospital.

Incidence of coronary heart disease deaths has been reported to be higher in low socioeconomic groups compared to affluent subjects. In addition, a higher mortality rate has been reported at centers doing fewer open heart surgeries. This article presents evidence in variance with these convictions. We report a single team's experience with coronary artery surgery on 76 low socioeconomic, predominantly black patients (84%) over a period of 8 years. The volume of open heart surgery per year was less than 20. The overall mortality rate of 5.3%, infection rate of 1.3%, and perioperative infarction rate of 7.9% are not significantly different from the reported experience of high-volume surgical centers on similar patients during the same period. Thus, it is possible to obtain comparable results of myocardial revascularization surgery in low-volume, socioeconomically disadvantaged, inner city minority populations.