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Al Mosa A, Bernier PL, Tchervenkov CI. Considerations in Timing of Surgical Repair in Tetralogy of Fallot. CJC Pediatr Congenit Heart Dis 2023; 2:361-367. [PMID: 38161680 PMCID: PMC10755837 DOI: 10.1016/j.cjcpc.2023.10.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 10/11/2023] [Indexed: 01/03/2024]
Abstract
Certain aspects of the treatment of tetralogy of Fallot (TOF) repair remain controversial. The optimal timing of the elective repair of asymptomatic patients and the ideal strategy for managing symptomatic neonates and infants with TOF are still debated despite years of experience in TOF treatment. In this article, we discuss why a surgical correction at 3-6 months of age is likely the ideal time frame for the elective repair of TOF. We also elaborate on our strategy for managing symptomatic neonates and infants with TOF and why we prefer an early single-stage primary repair.
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Affiliation(s)
- Alqasem Al Mosa
- Cardiovascular Surgery Unit, McGill University Health Center, Montreal, Québec, Canada
| | - Pierre-Luc Bernier
- McGill University Health Center, Pediatric Cardiovascular Surgery, McGill University, Montreal, Québec, Canada
| | - Christo I. Tchervenkov
- McGill University Health Center, Pediatric Cardiovascular Surgery, McGill University, Montreal, Québec, Canada
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2
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Jacobs JP, Bleiweis MS, Cohen MS, Lopez L, Peek GJ, Franklin RCG, Tchervenkov CI. Defining the Spectrum of Hypoplastic Left Heart Syndrome (HLHS). World J Pediatr Congenit Heart Surg 2023; 14:741-745. [PMID: 37933696 DOI: 10.1177/21501351231189277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2023]
Abstract
The 2021 International Paediatric and Congenital Cardiac Code and the Eleventh Revision of the International Classification of Diseases provide the following definition for hypoplastic left heart syndrome (HLHS): "Hypoplastic left heart syndrome (HLHS) is defined as a spectrum of congenital cardiovascular malformations with normally aligned great arteries without a common atrioventricular junction, characterized by underdevelopment of the left heart with significant hypoplasia of the left ventricle including atresia, stenosis, or hypoplasia of the aortic or mitral valve, or both valves, and hypoplasia of the ascending aorta and aortic arch." Although HLHS with intact ventricular septum (HLHS + IVS) and HLHS with ventricular septal defect (HLHS + VSD) are different cardiac phenotypes, both of these lesions are part of the spectrum of HLHS.
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Affiliation(s)
- Jeffrey P Jacobs
- Division of Cardiovascular Surgery, Departments of Surgery and Pediatrics, Congenital Heart Center, University of Florida, Gainesville, FL, United States of America
| | - Mark S Bleiweis
- Division of Cardiovascular Surgery, Departments of Surgery and Pediatrics, Congenital Heart Center, University of Florida, Gainesville, FL, United States of America
| | - Meryl S Cohen
- Cardiac Center, Children's Hospital of Philadelphia, Philadelphia, PA, United States of America
| | - Leo Lopez
- Lucile Packard Children's Hospital Stanford, Stanford University School of Medicine, Palo Alto, CA, United States of America
| | - Giles J Peek
- Division of Cardiovascular Surgery, Departments of Surgery and Pediatrics, Congenital Heart Center, University of Florida, Gainesville, FL, United States of America
| | - Rodney C G Franklin
- Paediatric Cardiology Department, Royal Brompton & Harefield NHS Trust, London, United Kingdom
| | - Christo I Tchervenkov
- Division of Cardiovascular Surgery, The Montreal Children's Hospital of the McGill University Health Centre, Montréal, Québec, Canada
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3
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Jacobs JP, DeCampli WM, Karamlou T, Najm HK, Marino BS, Blackstone EH, McCrindle BW, Jegatheeswaran A, St Louis JD, Austin EH, Caldarone CA, Mavroudis C, Overman DM, Dearani JA, Jacobs ML, Tchervenkov CI, Svensson LG, Barron D, Kirklin JK, Williams WG. The Academic Impact of Congenital Heart Surgeons' Society (CHSS) Studies. World J Pediatr Congenit Heart Surg 2023; 14:602-619. [PMID: 37737599 DOI: 10.1177/21501351231190916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/23/2023]
Abstract
PURPOSE We reviewed all 64 articles ever published by The Congenital Heart Surgeons' Society (CHSS) Data Center to estimate the academic impact of these peer-reviewed articles. MATERIALS AND METHODS The Congenital Heart Surgeons' Society has performed research based on 12 Diagnostic Inception Cohorts. The first cohort (Transposition) began enrolling patients on January 1, 1985. We queried PubMed to determine the number of publications that referenced each of the 64 journal articles generated by the datasets of the 12 Diagnostic Inception Cohorts that comprise the CHSS Database. Descriptive summaries of the data were tabulated using mean with standard deviation and median with range. RESULTS Sixty-four peer-reviewed papers have been published based on the CHSS Database. Fifty-nine peer-reviewed articles have been published based on the 12 Diagnostic Inception Cohorts, and five additional articles have been published based on Data Science. Excluding the recently established Diagnostic Inception Cohort for patients with Ebstein malformation of tricuspid valve, the number of papers published per cohort ranged from 1 for coarctation to 11 for transposition of the great arteries. The 11 articles generated from the CHSS Transposition Cohort were referenced by a total of 111 articles (median number of references per journal article = 9 [range = 0-22, mean = 10.1]). Overall, individual articles were cited by an average of 11 (mean), and a maximum of 41 PubMed-listed publications. Overall, these 64 peer-reviewed articles based on the CHSS Database were cited 692 times in PubMed-listed publications. The first CHSS peer-reviewed article was published in 1987, and during the 35 years from 1987 to 2022, inclusive, the annual number of CHSS publications has ranged from 0 to 7, with a mean of 1.8 publications per year (median = 1, mode = 1). CONCLUSION Congenital Heart Surgeons' Society studies are widely referenced in the pediatric cardiac surgical literature, with over 10 citations per published article. These cohorts provide unique information unavailable in other sources of data. A tool to access this analysis is available at: [https://data-center.chss.org/multimedia/files/2022/CAI.pdf].
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Affiliation(s)
- Jeffrey Phillip Jacobs
- Congenital Heart Center, Division of Cardiovascular Surgery, Departments of Surgery and Pediatrics, University of Florida, Gainesville, FL, USA
| | - William M DeCampli
- Division of Pediatric Cardiac Surgery, Arnold Palmer Hospital for Children, Orlando, FL, USA
| | - Tara Karamlou
- Pediatric and Adult Congenital Heart Center, Cleveland Clinic, Cleveland, OH, USA
| | - Hani K Najm
- Pediatric and Adult Congenital Heart Center, Cleveland Clinic, Cleveland, OH, USA
| | - Bradley S Marino
- Pediatric and Adult Congenital Heart Center, Cleveland Clinic, Cleveland, OH, USA
| | - Eugene H Blackstone
- Pediatric and Adult Congenital Heart Center, Cleveland Clinic, Cleveland, OH, USA
| | - Brian W McCrindle
- Division of Pediatric Cardiology, Hospital for Sick Children, Toronto, Ontario, Canada
| | | | - James D St Louis
- Department of Cardiac Surgery, Inova Fairfax Hospital and Inova L.J Murphy Children's Hospital, Fairfax, VA, USA
- Departments of Surgery and Pediatrics, Children's Hospital of Georgia, Augusta University, Augusta, GA, USA
| | - Erle H Austin
- Department of Cardiovascular and Thoracic Surgery, University of Louisville, Louisville, KY, USA
- Norton Children's Hospital, Louisville, KY, USA
| | | | - Constantine Mavroudis
- Pediatric Cardiothoracic Surgery, Peyton Manning Children's Hospital, Indianapolis, IN, USA
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - David M Overman
- Division of Cardiovascular Surgery, Mayo Clinic-Children's Minnesota Cardiovascular Collaborative, Minneapolis, MN, USA
| | - Joseph A Dearani
- Division of Cardiovascular Surgery, Mayo Clinic-Children's Minnesota Cardiovascular Collaborative, Minneapolis, MN, USA
| | - Marshall L Jacobs
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Christo I Tchervenkov
- Division of Cardiovascular Surgery, The Montreal Children's Hospital, McGill University Health Centre, Montreal, Québec, Canada
| | - Lars G Svensson
- Pediatric and Adult Congenital Heart Center, Cleveland Clinic, Cleveland, OH, USA
| | - David Barron
- Division of Cardiovascular Surgery, Hospital for Sick Children, Toronto, Ontario, Canada
| | - James K Kirklin
- Kirklin Institute for Research in Surgical Outcomes, Birmingham, AL, USA
| | - William G Williams
- Division of Cardiovascular Surgery, Hospital for Sick Children, Toronto, Ontario, Canada
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4
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Zheleva B, Verstappen A, Overman DM, Ahmad F, Ali SKM, Al Halees ZY, Atallah JG, Badhwar IE, Baker-Smith C, Balestrini M, Basken A, Bassuk JS, Benson L, Capelli H, Carollo S, Chowdhury D, Çiçek MS, Cohen MI, Cooper DS, Deanfield JE, Dearani J, Del Valle B, Dodds KM, Du J, Edwin F, Ekure E, Fatema NN, Gomanju A, Hasan B, Henry L, Hugo-Hamman C, Iyer KS, Jatene MB, Jenkins KJ, Karamlou T, Karl TR, Kirklin JK, Kreutzer C, Kumar RK, Lopez KN, Macedo AP, Marino BS, Marwali EM, Meijboom FJ, Mattos SS, Najm H, Newlin D, Novick WM, Qureshi SSA, Rahmat B, Raylman R, Saltik IL, Sable C, Sandoval N, Saxena A, Scanlan E, Sholler GF, Smith J, St Louis JD, Tchervenkov CI, Tiong KG, Vida V, Vosloo S, Weinstein DJD, Wilkinson JL, Zuhlke L, Jacobs JP. Advocacy at the Eighth World Congress of Pediatric Cardiology and Cardiac Surgery. Cardiol Young 2023; 33:1277-1287. [PMID: 37615116 DOI: 10.1017/s1047951123002688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/25/2023]
Abstract
The Eighth World Congress of Pediatric Cardiology and Cardiac Surgery (WCPCCS) will be held in Washington DC, USA, from Saturday, 26 August, 2023 to Friday, 1 September, 2023, inclusive. The Eighth World Congress of Pediatric Cardiology and Cardiac Surgery will be the largest and most comprehensive scientific meeting dedicated to paediatric and congenital cardiac care ever held. At the time of the writing of this manuscript, The Eighth World Congress of Pediatric Cardiology and Cardiac Surgery has 5,037 registered attendees (and rising) from 117 countries, a truly diverse and international faculty of over 925 individuals from 89 countries, over 2,000 individual abstracts and poster presenters from 101 countries, and a Best Abstract Competition featuring 153 oral abstracts from 34 countries. For information about the Eighth World Congress of Pediatric Cardiology and Cardiac Surgery, please visit the following website: [www.WCPCCS2023.org]. The purpose of this manuscript is to review the activities related to global health and advocacy that will occur at the Eighth World Congress of Pediatric Cardiology and Cardiac Surgery.Acknowledging the need for urgent change, we wanted to take the opportunity to bring a common voice to the global community and issue the Washington DC WCPCCS Call to Action on Addressing the Global Burden of Pediatric and Congenital Heart Diseases. A copy of this Washington DC WCPCCS Call to Action is provided in the Appendix of this manuscript. This Washington DC WCPCCS Call to Action is an initiative aimed at increasing awareness of the global burden, promoting the development of sustainable care systems, and improving access to high quality and equitable healthcare for children with heart disease as well as adults with congenital heart disease worldwide.
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Affiliation(s)
| | - Amy Verstappen
- Global Alliance for Rheumatic and Congenital Hearts, Kathmandu, Nepal
| | - David M Overman
- The Children's Heart Clinic, Children's Minnesota, Mayo Clinic-Children's Minnesota Cardiovascular Collaborative, Minneapolis, MN, USA
| | - Farhan Ahmad
- Pakistan Children's Heart Foundation, Lahore, Pakistan
| | - Sulafa K M Ali
- Sudan Heart Center & University of Khartoum, Khartoum, Sudan
| | - Zohair Y Al Halees
- King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | | | | | | | - Maria Balestrini
- National Pediatric Hospital JP Garrahan, Buenos Aires, Argentina
| | | | | | - Lee Benson
- The Hospital for Sick Children, Toronto, ON, Canada
| | - Horacio Capelli
- National Pediatric Hospital JP Garrahan, Buenos Aires, Argentina
| | | | - Devyani Chowdhury
- Nemours Cardiac Center, Wilmington, DE, USA and Cardiology Care for Children, Lancaster, USA
| | - M Sertaç Çiçek
- Department of Cardiovascular Surgery, Istanbul University, Istanbul Faculty of Medicine, and Liv Hospital VadIstanbul-Istinye University, Istanbul, Turkey
| | | | - David S Cooper
- Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - John E Deanfield
- Great Ormond Street Hospital (GOSH) for Children and University College London, London, UK
| | - Joseph Dearani
- Mayo Clinic, Mayo Clinic-Children's Minnesota Cardiovascular Collaborative, Minneapolis, MN, USA
| | | | | | - Junbao Du
- Peking University First Hospital, Beijing, China
| | - Frank Edwin
- Ho School of Medicine, University of Health & Allied Sciences; Ho Teaching Hospital, Volta Region, Ghana
| | - Ekanem Ekure
- College of Medicine, University of Lagos & Lagos University Teaching Hospital, Lagos, Nigeria
| | | | - Anu Gomanju
- Global Alliance for Rheumatic and Congenital Hearts, Kathmandu Institute of Child Health, Kathmandu, Nepal
| | - Babar Hasan
- Sindh Institute of Urology & Transplantation, Karachi, Pakistan
| | - Lewis Henry
- Cardiac Kids Foundation of FL, Oldsmar, FL, USA
| | | | | | | | - Kathy J Jenkins
- Harvard Medical School, Boston Children's Hospital, Boston, MA, USA
| | | | - Tom R Karl
- Paediatric Cardiac Research, University of Queensland, St Lucia, Australia
| | | | - Christián Kreutzer
- Division of Pediatric Cardiovascular Surgery, Hospital Universitario Austral, Buenos Aires, Argentina
| | - Raman Krishna Kumar
- Amrita Institute of Medical Sciences and Research Centre, Amrita Vishwa Vidyapeetham, Kochi, KL, India
| | - Keila N Lopez
- Texas Children's Hospital/Baylor College of Medicine, Houston, TX, USA
| | - Alexis Palacios Macedo
- Instituto Nacional de Pediatría; Centro Pediátrico del Corazón CM-ABC; Kardias AC, Mexico City, Mexico
| | | | - Eva M Marwali
- National Cardiovascular Center Harapan Kita, Jakarta, Indonesia
| | | | - Sandra S Mattos
- Real Hospital Português de Beneficência em Pernambuco, Círculo do Coração, Recife, Brazil
| | - Hani Najm
- Cleveland Clinic, Cleveland, OH, USA
| | | | - William M Novick
- William Novick Cardiac Alliance, University of Tennessee Health Science Center Global Surgical Institute, Memphis, TN, USA
| | | | - Budi Rahmat
- National Cardiovascular Center Harapan Kita, Jakarta, Indonesia
| | | | | | - Craig Sable
- Children's National Hospital, Children's National Health System, Washington, District of Columbia, USA
| | - Nestor Sandoval
- Fundacion Cardioinfantil-Instituto de Cardiologia, Bogota, Colombia
| | - Anita Saxena
- Pt. B.D. Sharma University of Health Sciences, Rohtak, India
| | | | - Gary F Sholler
- Heart Centre for Children, Sydney Children's Hospitals Network & University of Sydney, Westmead, Australia
| | | | - James D St Louis
- Inova Fairfax Hospital and Inova L.J. Murphy Children's Hospital, Fairfax, and Children's Hospital of Georgia and Augusta University, Augusta, GA, USA
| | - Christo I Tchervenkov
- The Montreal Children's Hospital of the McGill University Health Centre, Montréal, QC, Canada
| | | | - Vladimiro Vida
- Pediatric and Congenital Cardiac Surgery Unit, University of Padova, Padova, Italy
| | - Susan Vosloo
- Christiaan Barnard Memorial Hospital, Cape Town, South Africa
| | | | - James L Wilkinson
- Royal Children's Hospital and University of Melbourne, Melbourne, Australia
| | - Liesl Zuhlke
- University of Cape Town; South African Medical Research Council, Cape Town, South Africa
| | - Jeffrey P Jacobs
- Cardiac Kids Foundation of FL, Oldsmar, FL, USA
- Congenital Heart Center, Division of Cardiovascular Surgery, Departments of Surgery and Pediatrics, University of Florida, Gainesville, FL, USA
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5
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Tretter JT, Spicer DE, Franklin RCG, Béland MJ, Aiello VD, Cook AC, Crucean A, Loomba RS, Yoo SJ, Quintessenza JA, Tchervenkov CI, Jacobs JP, Najm HK, Anderson RH. Expert Consensus Statement: Anatomy, Imaging, and Nomenclature of Congenital Aortic Root Malformations. Cardiol Young 2023; 33:1060-1068. [PMID: 37288941 DOI: 10.1017/s1047951123001233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Over the past 2 decades, several categorizations have been proposed for the abnormalities of the aortic root. These schemes have mostly been devoid of input from specialists of congenital cardiac disease. The aim of this review is to provide a classification, from the perspective of these specialists, based on an understanding of normal and abnormal morphogenesis and anatomy, with emphasis placed on the features of clinical and surgical relevance. We contend that the description of the congenitally malformed aortic root is simplified when approached in a fashion that recognizes the normal root to be made up of 3 leaflets, supported by their own sinuses, with the sinuses themselves separated by the interleaflet triangles. The malformed root, usually found in the setting of 3 sinuses, can also be found with 2 sinuses, and very rarely with 4 sinuses. This permits description of trisinuate, bisinuate, and quadrisinuate variants, respectively. This feature then provides the basis for classification of the anatomical and functional number of leaflets present. By offering standardized terms and definitions, we submit that our classification will be suitable for those working in all cardiac specialties, whether pediatric or adult. It is of equal value in the settings of acquired or congenital cardiac disease. Our recommendations will serve to amend and/or add to the existing International Paediatric and Congenital Cardiac Code, along with the Eleventh iteration of the International Classification of Diseases provided by the World Health Organization.
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Affiliation(s)
- Justin T Tretter
- Department of Pediatric Cardiology, Cleveland Clinic Children's and The Heart, Vascular, and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio
| | - Diane E Spicer
- Heart Institute, Johns Hopkins All Children's Hospital, St Petersburg, Florida
- Congenital Heart Center, UF Health Shands Hospital, Division of Cardiovascular Surgery, Departments of Surgery and Pediatrics, University of Florida, Gainesville, Florida
| | - Rodney C G Franklin
- Paediatric Cardiology Department, Royal Brompton & Harefield National Health Service Trust, London, United Kingdom
| | - Marie J Béland
- Division of Pediatric Cardiology, The Montreal Children's Hospital of the McGill University Health Centre, Montréal, Québec, Canada
| | - Vera D Aiello
- Heart Institute (InCor), University of São Paulo School of Medicine, São Paulo, Brazil
| | - Andrew C Cook
- Institute of Cardiovascular Science, University College London, London, United Kingdom
| | - Adrian Crucean
- Department of Paediatric Cardiac Surgery, Birmingham Women's and Children's Hospital, Birmingham, United Kingdom
| | - Rohit S Loomba
- Division of Cardiology, Advocate Children's Hospital, Oak Lawn, Illinois
| | - Shi-Joon Yoo
- Division of Cardiology, Department of Pediatrics, Labatt Family Heart Centre, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | | | - Christo I Tchervenkov
- Division of Cardiovascular Surgery, The Montreal Children's Hospital of the McGill University Health Centre, Montréal, Québec, Canada
| | - Jeffrey P Jacobs
- Congenital Heart Center, UF Health Shands Hospital, Division of Cardiovascular Surgery, Departments of Surgery and Pediatrics, University of Florida, Gainesville, Florida
| | - Hani K Najm
- Division of Pediatric Cardiac Surgery, Cleveland Clinic Children's and the Heart, Vascular, and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio
| | - Robert H Anderson
- Cardiovascular Research Centre, Biosciences Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
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6
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Tchervenkov CI, Kirklin JK, Jonas RA, Backer CL. A Warm Welcome to Our African Colleagues. World J Pediatr Congenit Heart Surg 2023; 14:415-416. [PMID: 37410598 DOI: 10.1177/21501351231177262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/08/2023]
Affiliation(s)
- Christo I Tchervenkov
- Division of Pediatric Cardiovascular Surgery, Montreal Children's Hospital, McGill University Health Center, Montreal, Quebec, Canada
| | | | - Richard A Jonas
- Department of Cardiac Surgery, Children's National Hospital, Washington, DC, USA
| | - Carl L Backer
- Section of Pediatric Cardiothoracic Surgery, UK HealthCare Kentucky Children's Hospital, Lexington, KY, USA
- Department of Cardiothoracic Surgery, Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
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7
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Tretter JT, Spicer DE, Franklin RCG, Béland MJ, Aiello VD, Cook AC, Crucean A, Loomba RS, Yoo SJ, Quintessenza JA, Tchervenkov CI, Jacobs JP, Najm HK, Anderson RH. Expert Consensus Statement: Anatomy, Imaging, and Nomenclature of Congenital Aortic Root Malformations. Ann Thorac Surg 2023; 116:6-16. [PMID: 37294261 DOI: 10.1016/j.athoracsur.2023.03.023] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 02/03/2023] [Accepted: 03/15/2023] [Indexed: 06/10/2023]
Abstract
Over the past 2 decades, several categorizations have been proposed for the abnormalities of the aortic root. These schemes have mostly been devoid of input from specialists of congenital cardiac disease. The aim of this review is to provide a classification, from the perspective of these specialists, based on an understanding of normal and abnormal morphogenesis and anatomy, with emphasis placed on the features of clinical and surgical relevance. We contend that the description of the congenitally malformed aortic root is simplified when approached in a fashion that recognizes the normal root to be made up of 3 leaflets, supported by their own sinuses, with the sinuses themselves separated by the interleaflet triangles. The malformed root, usually found in the setting of 3 sinuses, can also be found with 2 sinuses, and very rarely with 4 sinuses. This permits description of trisinuate, bisinuate, and quadrisinuate variants, respectively. This feature then provides the basis for classification of the anatomical and functional number of leaflets present. By offering standardized terms and definitions, we submit that our classification will be suitable for those working in all cardiac specialties, whether pediatric or adult. It is of equal value in the settings of acquired or congenital cardiac disease. Our recommendations will serve to amend and/or add to the existing International Paediatric and Congenital Cardiac Code, along with the Eleventh iteration of the International Classification of Diseases provided by the World Health Organization.
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Affiliation(s)
- Justin T Tretter
- Department of Pediatric Cardiology, Cleveland Clinic Children's and The Heart, Vascular, and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio.
| | - Diane E Spicer
- Heart Institute, Johns Hopkins All Children's Hospital, St Petersburg, Florida; Congenital Heart Center, UF Health Shands Hospital, Division of Cardiovascular Surgery, Departments of Surgery and Pediatrics, University of Florida, Gainesville, Florida
| | - Rodney C G Franklin
- Paediatric Cardiology Department, Royal Brompton & Harefield National Health Service Trust, London, United Kingdom
| | - Marie J Béland
- Division of Pediatric Cardiology, The Montreal Children's Hospital of the McGill University Health Centre, Montréal, Québec, Canada
| | - Vera D Aiello
- Heart Institute (InCor), University of São Paulo School of Medicine, São Paulo, Brazil
| | - Andrew C Cook
- Institute of Cardiovascular Science, University College London, London, United Kingdom
| | - Adrian Crucean
- Department of Paediatric Cardiac Surgery, Birmingham Women's and Children's Hospital, Birmingham, United Kingdom
| | - Rohit S Loomba
- Division of Cardiology, Advocate Children's Hospital, Oak Lawn, Illinois
| | - Shi-Joon Yoo
- Division of Cardiology, Department of Pediatrics, Labatt Family Heart Centre, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | | | - Christo I Tchervenkov
- Division of Cardiovascular Surgery, The Montreal Children's Hospital of the McGill University Health Centre, Montréal, Québec, Canada
| | - Jeffrey P Jacobs
- Congenital Heart Center, UF Health Shands Hospital, Division of Cardiovascular Surgery, Departments of Surgery and Pediatrics, University of Florida, Gainesville, Florida
| | - Hani K Najm
- Division of Pediatric Cardiac Surgery, Cleveland Clinic Children's and the Heart, Vascular, and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio
| | - Robert H Anderson
- Cardiovascular Research Centre, Biosciences Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
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8
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Tchervenkov CI, Tang R, Jacobs JP. Hypoplastic Left Ventricle: Hypoplastic Left Heart Complex. World J Pediatr Congenit Heart Surg 2022; 13:631-636. [PMID: 36053097 DOI: 10.1177/21501351221116016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Hypoplastic left heart syndrome (HLHS) without intrinsic valvar stenosis or atresia is synonymous with the term hypoplastic left heart complex (HLHC) and is defined as a cardiac malformation at the milder end of the spectrum of HLHS with normally aligned great arteries without a common atrioventricular junction, characterized by underdevelopment of the left heart with significant hypoplasia of the left ventricle and hypoplasia of the aortic or mitral valve, or both valves, in the absence of intrinsic valvar stenosis or atresia, and with hypoplasia of the ascending aorta and aortic arch. This article describes the definitions, nomenclature, and classification of HLHC; the indications and contraindications for biventricular repair of HLHC; the surgical treatment of HLHC; and the associated outcomes.
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Affiliation(s)
- Christo I Tchervenkov
- Division of Cardiovascular Surgery, 10040The Montreal Children's Hospital, McGill University Health Centre, Montreal, Quebec, Canada
| | - Richard Tang
- Division of Cardiovascular Surgery, 10040The Montreal Children's Hospital, McGill University Health Centre, Montreal, Quebec, Canada
| | - Jeffrey P Jacobs
- Congenital Heart Center, Division of Cardiovascular Surgery, Departments of Surgery and Pediatrics, 3463University of Florida, Gainesville, FL, USA
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9
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St Louis JD, Deng L, Covington C, Timkovich NA, Crethers D, Collum CS, Pennington JK, Broser T, Dabal RJ, Jacobs JP, O'Brien JE, Austin EH, Tchervenkov CI, Kirklin JK. The World Society for Pediatric and Congenital Heart Surgery: 2021 Update of the World Database for Pediatric and Congenital Heart Surgery. World J Pediatr Congenit Heart Surg 2022; 13:137-145. [PMID: 35238707 DOI: 10.1177/21501351221075604] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The World Database for Pediatric and Congenital Heart Surgery (WDPCHS), sponsored by the World Society for Pediatric and Congenital Heart Surgery (WSPCHS), provides complex programmatic outcomes analyses for all members of the WSPCHS. METHODS The Data center, currently at Kirklin Institute for Research in Surgical Outcomes (KIRSO), University of Alabama, Birmingham (USA), provides biannual reports to all active members of the database. This report presents a descriptive analysis of these procedures submitted from January 1, 2017 to December 31, 2020. RESULTS A total of 37,386 procedures were submitted with an overall mortality of 4.3%. The majority of submissions were from Asian countries. The majority of cases submitted from these countries were of Society of Thoracic Surgeons (STS)-European Association for Cardio-Thoracic Surgery (STAT) Mortality Categories I and II. CONCLUSIONS The WSPCHS accomplished one of its missions in 2017 when the WDPCHS began accepting data from pediatric and congenital heart surgery programs across the globe. In doing so, it became one of the first organizations to create a platform for the exchange of knowledge and experience, regardless of the socioeconomic status of the particular program or country.
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Affiliation(s)
| | - Luqin Deng
- KIRSO, University of Alabama at Birmingham, Birmingham, AL, USA
| | | | | | | | - Craig S Collum
- KIRSO, University of Alabama at Birmingham, Birmingham, AL, USA
| | | | - Taylor Broser
- KIRSO, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Robert J Dabal
- KIRSO, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Jeffrey P Jacobs
- Division of Cardiovascular Surgery, Departments of Surgery, University of Florida, Gainesville, FL, USA
| | - James E O'Brien
- Department of Surgery, Children's Mercy Hospital, Kansas City, MO, USA
| | - Erle H Austin
- Department of Surgery, University of Louisville, Louisville, KY, USA
| | - Christo I Tchervenkov
- Division of Pediatric Cardiovascular Surgery, The Montreal Children's Hospital of the McGill University Health Centre, Montreal, Quebec, Canada
| | - James K Kirklin
- KIRSO, University of Alabama at Birmingham, Birmingham, AL, USA
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10
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Jacobs JP, Franklin RCG, Béland MJ, Spicer DE, Colan SD, Walters HL, Bailliard F, Houyel L, St Louis JD, Lopez L, Aiello VD, Gaynor JW, Krogmann ON, Kurosawa H, Maruszewski BJ, Stellin G, Weinberg PM, Jacobs ML, Boris JR, Cohen MS, Everett AD, Giroud JM, Guleserian KJ, Hughes ML, Juraszek AL, Seslar SP, Shepard CW, Srivastava S, Cook AC, Crucean A, Hernandez LE, Loomba RS, Rogers LS, Sanders SP, Savla JJ, Tierney ESS, Tretter JT, Wang L, Elliott MJ, Mavroudis C, Tchervenkov CI. Nomenclature for Pediatric and Congenital Cardiac Care: Unification of Clinical and Administrative Nomenclature - The 2021 International Paediatric and Congenital Cardiac Code (IPCCC) and the Eleventh Revision of the International Classification of Diseases (ICD-11). World J Pediatr Congenit Heart Surg 2021; 12:E1-E18. [PMID: 34304616 DOI: 10.1177/21501351211032919] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Substantial progress has been made in the standardization of nomenclature for paediatric and congenital cardiac care. In 1936, Maude Abbott published her Atlas of Congenital Cardiac Disease, which was the first formal attempt to classify congenital heart disease. The International Paediatric and Congenital Cardiac Code (IPCCC) is now utilized worldwide and has most recently become the paediatric and congenital cardiac component of the Eleventh Revision of the International Classification of Diseases (ICD-11). The most recent publication of the IPCCC was in 2017. This manuscript provides an updated 2021 version of the IPCCC. The International Society for Nomenclature of Paediatric and Congenital Heart Disease (ISNPCHD), in collaboration with the World Health Organization (WHO), developed the paediatric and congenital cardiac nomenclature that is now within the eleventh version of the International Classification of Diseases (ICD-11). This unification of IPCCC and ICD-11 is the IPCCC ICD-11 Nomenclature and is the first time that the clinical nomenclature for paediatric and congenital cardiac care and the administrative nomenclature for paediatric and congenital cardiac care are harmonized. The resultant congenital cardiac component of ICD-11 was increased from 29 congenital cardiac codes in ICD-9 and 73 congenital cardiac codes in ICD-10 to 318 codes submitted by ISNPCHD through 2018 for incorporation into ICD-11. After these 318 terms were incorporated into ICD-11 in 2018, the WHO ICD-11 team added an additional 49 terms, some of which are acceptable legacy terms from ICD-10, while others provide greater granularity than the ISNPCHD thought was originally acceptable. Thus, the total number of paediatric and congenital cardiac terms in ICD-11 is 367. In this manuscript, we describe and review the terminology, hierarchy, and definitions of the IPCCC ICD-11 Nomenclature. This article, therefore, presents a global system of nomenclature for paediatric and congenital cardiac care that unifies clinical and administrative nomenclature.The members of ISNPCHD realize that the nomenclature published in this manuscript will continue to evolve. The version of the IPCCC that was published in 2017 has evolved and changed, and it is now replaced by this 2021 version. In the future, ISNPCHD will again publish updated versions of IPCCC, as IPCCC continues to evolve.
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Affiliation(s)
- Jeffrey P Jacobs
- Congenital Heart Center, UF Health Shands Hospital, Division of Cardiovascular Surgery, Departments of Surgery and Pediatrics, University of Florida, Gainesville, Florida, United States of America
| | - Rodney C G Franklin
- Paediatric Cardiology Department, Royal Brompton & Harefield NHS Trust, London, United Kingdom
| | - Marie J Béland
- Division of Paediatric Cardiology, The Montreal Children's Hospital of the McGill University Health Centre, Montréal, Québec, Canada
| | - Diane E Spicer
- Congenital Heart Center, UF Health Shands Hospital, Division of Cardiovascular Surgery, Departments of Surgery and Pediatrics, University of Florida, Gainesville, Florida, United States of America.,Johns Hopkins All Children's Hospital, Johns Hopkins University, Saint Petersburg, Florida, United States of America
| | - Steven D Colan
- Department of Cardiology, Boston Children's Hospital, Harvard University, Boston, Massachusetts, United States of America
| | - Henry L Walters
- Cardiovascular Surgery, Children's Hospital of Michigan, Wayne State University School of Medicine, Detroit, Michigan, United States of America
| | - Frédérique Bailliard
- Bailliard Henry Pediatric Cardiology, Raleigh, North Carolina, United States of America.,Duke University, Durham, North Carolina, United States of America
| | - Lucile Houyel
- Congenital and Pediatric Medico-Surgical Unit, Necker Hospital-M3C, Paris, France
| | - James D St Louis
- Department of Surgery and Pediatrics, Children Hospital of Georgia, Augusta University, Augusta, Georgia
| | - Leo Lopez
- Lucile Packard Children's Hospital Stanford, Stanford University School of Medicine, Palo Alto, California, United States of America
| | - Vera D Aiello
- Heart Institute (InCor), University of São Paulo School of Medicine, São Paulo, Brazil
| | - J William Gaynor
- Cardiac Center, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, United States of America
| | - Otto N Krogmann
- Pediatric Cardiology-Congenital Heart Disease, Heart Center Duisburg, Duisburg, Germany
| | - Hiromi Kurosawa
- Cardiovascular Surgery, Tokyo Women's Medical University, Tokyo, Japan
| | - Bohdan J Maruszewski
- Department for Pediatric and Congenital Heart Surgery, Children's Memorial Health Institute, Warsaw, Poland
| | - Giovanni Stellin
- Pediatric and Congenital Cardiac Surgical Unit, Department of Cardiothoracic and Vascular Sciences, University of Padova, Padova, Italy
| | - Paul Morris Weinberg
- Cardiac Center, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, United States of America
| | | | - Jeffrey R Boris
- Jeffrey R. Boris, MD LLC, Moylan, Pennsylvania, United States of America
| | - Meryl S Cohen
- Cardiac Center, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, United States of America
| | - Allen D Everett
- Johns Hopkins University, Baltimore, Maryland, United States of America
| | - Jorge M Giroud
- All Children's Hospital, Saint Petersburg, Florida, United States of America
| | - Kristine J Guleserian
- Congenital Heart Surgery, Medical City Children's Hospital, Dallas, Texas, United States of America
| | - Marina L Hughes
- Cardiology Department, Norfolk and Norwich University Hospital NHS Trust, United Kingdom
| | - Amy L Juraszek
- Terry Heart Institute, Wolfson Children's Hospital, Jacksonville, Florida, United States of America
| | - Stephen P Seslar
- Department of Pediatrics, Division of Pediatric Cardiology, Seattle Children's Hospital, University of Washington, Seattle, Washington, United States of America
| | - Charles W Shepard
- Children's Heart Clinic of Minneapolis, Minneapolis, Minnesota, United States of America
| | - Shubhika Srivastava
- Division of Cardiology, Department of Cardiovascular Medicine, Nemours Cardiac Center at the Alfred I. duPont Hospital for Children, Wilmington, Delaware, United States of America
| | - Andrew C Cook
- Institute of Cardiovascular Science, University College London, London, United Kingdom
| | - Adrian Crucean
- Congenital Heart Surgery, Birmingham Women's and Children's Foundation Trust Hospital, University of Birmingham, Birmingham, United Kingdom
| | - Lazaro E Hernandez
- Joe DiMaggio Children's Hospital Heart Institute, Hollywood, Florida, United States of America
| | - Rohit S Loomba
- Advocate Children's Heart Institute, Advocate Children's Hospital, Oak Lawn, Illinois, United States of America
| | - Lindsay S Rogers
- Cardiac Center, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, United States of America
| | - Stephen P Sanders
- Cardiovascular Surgery, Children's Hospital of Michigan, Wayne State University School of Medicine, Detroit, Michigan, United States of America
| | - Jill J Savla
- Cardiac Center, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, United States of America
| | - Elif Seda Selamet Tierney
- Lucile Packard Children's Hospital Stanford, Stanford University School of Medicine, Palo Alto, California, United States of America
| | - Justin T Tretter
- Department of Pediatrics, Heart Institute, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, Ohio, United States of America
| | - Lianyi Wang
- Heart Centre, First Hospital of Tsinghua University, Beijing, China
| | | | - Constantine Mavroudis
- Johns Hopkins University, Baltimore, Maryland, United States of America.,Peyton Manning Children's Hospital, Indianapolis, Indiana, United States of America
| | - Christo I Tchervenkov
- Division of Cardiovascular Surgery, The Montreal Children's Hospital of the McGill University Health Centre, Montréal, Québec, Canada
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11
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Affiliation(s)
- Giovanni Stellin
- Pediatric and Congenital Cardiac Surgery Unit, 9308University of Padova, Padova, Italy
| | - Christo I Tchervenkov
- Division of Cardiovascular Surgery, The Montreal Children's Hospital of the McGill University Health Centre, Montreal, Quebec, Canada
| | - Richard A Jonas
- Cardiac Surgery, Center for Neuroscience Research, 8404Children's National Hospital, Washington, DC, USA
| | - Marshall L Jacobs
- 1466Johns Hopkins School of Medicine, Baltimore, Maryland, USA This article has been copublished in the World Journal for Pediatric and Congenital Heart Surgery and in Cardiology in the Young
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12
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Tchervenkov CI, Herbst C, Jacobs JP, Al-Halees Z, Edwin F, Dearani JA, Finucane K, Sandoval N, Sarris GE, Fragata J, Abdulgani HB, Arboleda M, Bacha EA, Barron DJ, Becker P, Boumzebra D, Cervantes J, Elgamal A, Helvind MH, Iyer KS, Jatene MB, Jun TG, Kirklin JK, Kreutzer C, Lee C, Lotto AA, Manuel V, Maruszewski B, Najm H, Overman D, Rahmat B, Reddy D, Sakamoto K, Samankatiwat P, Sivalingam S, St Louis JD, Stellin G, Stephens EH, Tretter JT, Truong NLT, Tweddell JS, Vida V, Vosloo S, Zhang H, Zheleva B, Jonas RA. Current Status of Training and Certification for Congenital Heart Surgery Around the World: Proceedings of the Meetings of the Global Council on Education for Congenital Heart Surgery of the World Society for Pediatric and Congenital Heart Surgery. World J Pediatr Congenit Heart Surg 2021; 12:394-405. [PMID: 33942697 DOI: 10.1177/21501351211003520] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The optimal training of the highly specialized congenital heart surgeon is a long and complex process, which is a significant challenge in most parts of the world. The World Society for Pediatric and Congenital Heart Surgery (WSPCHS) has established the Global Council on Education for Congenital Heart Surgery as a nonprofit organization with the goal of assessing current training and certification and ultimately establishing standardized criteria for the training, evaluation, and certification of congenital heart surgeons around the world. The Global Council and the WSPCHS have reviewed the present status of training and certification for congenital cardiac surgery around the world. There is currently lack of consensus and standardized criteria for training in congenital heart surgery, with significant disparity between continents and countries. This represents significant obstacles to international job mobility of competent congenital heart surgeons and to the efforts to improve the quality of care for patients with Congenital Heart Disease worldwide. The purpose of this article is to summarize and document the present state of training and certification in congenital heart surgery around the world.
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Affiliation(s)
- Christo I Tchervenkov
- Division of Cardiovascular Surgery, 10040The Montreal Children's Hospital of the McGill University Health Centre, Montreal, Quebec, Canada
| | - Claudia Herbst
- Department of Cardiac Surgery, Pediatric Cardiac Surgery, 27271Medical University of Vienna, Austria
| | - Jeffrey P Jacobs
- Division of Thoracic and Cardiovascular Surgery, Department of Surgery, University of Florida, Gainesville, USA
| | - Zohair Al-Halees
- Heart Center, 37852King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia
| | - Frank Edwin
- National Cardiothoracic Centre, Accra, Ghana.,University of Health and Allied Sciences, Ho, Ghana
| | - Joseph A Dearani
- Department of Cardiovascular Surgery, Mayo Clinic, Rochester, MN, USA
| | | | - Nestor Sandoval
- Department of Cardiac Surgery, Fundacion Cardioinfantil-Instituto de Cardiologia, Bogota, Colombia
| | | | - Jose Fragata
- Cardiothoracic Surgery, Santa Marta Hospital, NOVA Medical School, Lisbon, Portugal
| | | | - Miguel Arboleda
- Pediatric Cardiovascular Surgery, Instituto Nacional Cardiovascular (INCOR), Lima, Peru
| | - Emile A Bacha
- Department of Surgery, Section of Pediatric and Congenital Heart Surgery, Columbia University New York-Presbyterian/Morgan Stanley Children's Hospital, New York, NY, USA
| | - David J Barron
- Pediatric Cardiac Surgery, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Pedro Becker
- Cardiovascular Surgery, Faculty of Medicine, Pontifical Catholic University of Chile, Santiago, Chile
| | - Drissi Boumzebra
- Cardiovascular Surgery Unit, Mohamed VI University Hospital, Marrakech, Morocco
| | - Jorge Cervantes
- Department of Pediatric Cardiac and Congenital Heart Surgery, Instituto Nacional de Cardiologia Ignacio Chavez, Mexico City, Mexico
| | - Adel Elgamal
- Congenital and Pediatric Cardiac Surgery, Mansoura University Children's Hospital, Mansoura, Egypt
| | - Morten H Helvind
- Department of Congenital Heart Surgery, Rigshospitalet, University Hospital of Copenhagen, Denmark
| | - Krishna S Iyer
- Pediatric & Congenital Heart Surgery, Fortis-Escorts Heart Institute, New Delhi, India
| | | | | | - James K Kirklin
- Division of Cardiothoracic Surgery, University of Alabama at Birmingham, AL, USA
| | - Christian Kreutzer
- Division of Pediatric Cardiovascular Surgery, Hospital Universitario Austral, Buenos Aires, Argentina
| | - Cheul Lee
- Department of Thoracic and Cardiovascular Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Attilio A Lotto
- Pediatric Cardiac Surgery, Alder Hey Children's Hospital, Liverpool, United Kingdom
| | - Valdano Manuel
- Cardiovascular Surgery, Clinica Girassol, Luanda, Angola
| | - Bohdan Maruszewski
- Pediatric Cardiothoracic Surgery Department, Children's Memorial Health Institute, Warsaw, Poland
| | - Hani Najm
- Division of Cardiovascular Surgery, Pediatric and Congenital Heart Surgery, Cleveland Clinic, Cleveland, OH, USA
| | - David Overman
- Division of Cardiovascular Surgery, Children's Minnesota, Minneapolis, MN, USA
| | - Budi Rahmat
- Pediatric and Congenital Heart Surgery Division, National Cardiovascular Center, Harapan Kita, Jakarta, Indonesia
| | - Darshan Reddy
- Lenmed Ethekwini Hospital and Heart Centre, Nelson R. Mandela School of Medicine, Durban, South Africa
| | - Kisaburo Sakamoto
- Department of Cardiovascular Surgery, Mount Fuji Shizuoka Children's Hospital, Shizuoka, Japan
| | - Piya Samankatiwat
- Department of Surgery, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Sivakumar Sivalingam
- Department of Cardiothoracic Surgery, National Heart Institute, Kuala Lumpur, Malaysia
| | - James D St Louis
- Departments of Surgery and Pediatrics, Children's Hospital of Georgia, Augusta University, Augusta, GA, USA
| | - Giovanni Stellin
- Pediatric and Congenital Cardiac Surgery Unit, University of Padova, Padova, Italy
| | | | - Justin T Tretter
- Department of Pediatrics, University of Cincinnati College of Medicine, Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Nguyen Ly Thinh Truong
- Department of Cardiovascular Surgery, Children's Heart Center, National Children's Hospital, Hanoi, Vietnam
| | - James S Tweddell
- Cardiothoracic Surgery, Heart Institute, Cincinnati Children's Hospital Medical, Cincinnati, OH, USA
| | - Vladimiro Vida
- Pediatric and Congenital Cardiac Surgery Unit, University of Padova, Padova, Italy
| | - Susan Vosloo
- Christiaan Barnard Memorial Hospital, Cape Town, South Africa
| | - Hao Zhang
- Shanghai Children's Medical Center and National Medical Center, Shanghai, China
| | | | - Richard A Jonas
- Cardiac Surgery, Center for Neuroscience Research, Children's National Hospital, Washington, DC, USA
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13
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Bernier PL, Ota N, Tchervenkov CI, Jacobs JP, Stellin G, Kurosawa H, Mavroudis C, Cicek S, Al-Halees Z, Elliott M, Jatene M, Jonas RA, Kinsley R, Kreutzer C, Leon-Wyss J, Liu J, Maruszewski B, Nunn G, Ramirez-Marroquin S, Sandaval N, Sano S, Sarris G, Sharma R, Spray T, Ungerleider R, Yangni-Angate H, Ziemer G. AN INVITATION TO THE MEDICAL STUDENTS OF THE WORLD TO JOIN THE GLOBAL COALITION TO IMPROVE CARE FOR CHILDREN AND ADULTS WITH CONGENITAL HEART DISEASE ACROSS THE WORLD. Mcgill J Med 2020. [DOI: 10.26443/mjm.v11i2.567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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14
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Protopapas EM, Rito ML, Vida VL, Sarris GE, Tchervenkov CI, Maruszewski BJ, Tobota Z, Zheleva B, Zhang H, Jacobs JP, Dearani JA, Stephens EH, Tweddell JS, Sandoval NF, Bacha EA, Austin EH, Sakamoto K, Talwar S, Kurosawa H, Halees ZYA, Jatene MB, Iyer KS, Lee C, Sharma R, Hirata Y, Edwin F, Cervantes JL, O'Brien J, St Louis J, Kirklin JK. Early Impact of the COVID-19 Pandemic on Congenital Heart Surgery Programs Across the World: Assessment by a Global Multi-Societal Consortium. World J Pediatr Congenit Heart Surg 2020; 11:689-696. [PMID: 32844725 PMCID: PMC7450206 DOI: 10.1177/2150135120949462] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic currently gripping the globe is impacting the entire health care system with rapidly escalating morbidities and mortality. Although the infectious risk to the pediatric population appears low, the effects on children with congenital heart disease (CHD) remain poorly understood. The closure of congenital heart surgery programs worldwide to address the growing number of infected individuals could have an unintended impact on future health for COVID-19-negative patients with CHD. Pediatric and congenital heart surgeons, given their small numbers and close relationships, are uniquely positioned to collectively assess the impact of the pandemic on surgical practice and care of children with CHD. We present the results of an international survey sent to pediatric and congenital heart surgeons characterizing the early impact of COVID-19 on the care of patients with CHD.
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Affiliation(s)
| | - Mauro Lo Rito
- Department of Congenital Cardiac Surgery, 27288IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Vladimiro L Vida
- Pediatric and Congenital Cardiac Surgery Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, 9308University of Padua, Padua, Italy
| | | | - Christo I Tchervenkov
- Division of Pediatric Cardiovascular Surgery, The Montreal Children's Hospital of the McGill University Health Centre, Montreal, Quebec, Canada
| | - Bohdan J Maruszewski
- Pediatric Cardiothoracic Surgery Department, Children's Memorial Health Institute, Warsaw, Poland
| | - Zdzislaw Tobota
- Pediatric Cardiothoracic Surgery Department, Children's Memorial Health Institute, Warsaw, Poland
| | | | - Hao Zhang
- Department of Cardiothoracic Surgery, Heart Center, Shanghai Children Medical Center, National Center for Children Health, Shanghai, China
| | - Jeffery P Jacobs
- Division of thoracic and Cardiovascular Surgery, Department of Surgery, University of Florida, Gainesville, FL, USA
| | | | | | - James S Tweddell
- University of Cincinnati, Department of Cardiac Surgery, OH, USA
| | - Nestor F Sandoval
- Congenital Heart Institute, Fundacion Cardioinfantil-Instituto de Cardiologia, Bogota, Colombia
| | - Emile A Bacha
- Department of Surgery, Section of Pediatric and Congenital Heart Surgery, Columbia University New York-Presbyterian/Morgan Stanley Children's Hospital, New York, NY, USA
| | - Erle H Austin
- Department of Cardiovascular Surgery, University of Louisville, KY, USA
| | - Kisaburo Sakamoto
- Department of Cardiovascular Surgery, Mt. Fuji Shizuoka Children's Hospital, Shizuoka City, Japan
| | - Sachin Talwar
- Department of Cardiothoracic & Vascular Surgery, All India Institute of Medical Sciences, New Delhi, India
| | | | - Zohair Y Al Halees
- Heart Center, King Faisal Hospital & Research Centre, Riyadh, Saudi Arabia
| | | | - Krishna S Iyer
- Pediatric & Congenital Heart Surgery, Fortis-Escorts Heart Institute, New Delhi, India
| | - Cheul Lee
- Department of Thoracic and Cardiovascular Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Rajesh Sharma
- Pediatric Cardiac Surgery, Jaypee Hospital, Noida, India
| | - Yasutaka Hirata
- Department of Cardiac Surgery, University of Tokyo Hospital, Tokyo, Japan
| | - Frank Edwin
- Professor & Head of Cardiothoracic Surgery National Cardiothoracic Centre, Accra, Ghana
| | - Jorge L Cervantes
- Department of Pediatric Cardiac and Congenital Heart Disease Surgery, 42705Instituto Nacional de Cardiologia Ignacio Chavez, Mexico
| | - James O'Brien
- Division of Cardiac Surgery, 4204Children's Mercy Kansas City, MO, USA
| | - James St Louis
- Division of Cardiac Surgery, 4204Children's Mercy Kansas City, MO, USA
| | - James K Kirklin
- Division of Cardiothoracic Surgery, 9968University of Alabama at Birmingham, AL, USA
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15
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Stackhouse KA, McCrindle BW, Blackstone EH, Rajeswaran J, Kirklin JK, Bailey LL, Jacobs ML, Tchervenkov CI, Jacobs JP, Pettersson GB. Surgical palliation or primary transplantation for aortic valve atresia. J Thorac Cardiovasc Surg 2020; 159:1451-1461.e7. [DOI: 10.1016/j.jtcvs.2019.08.104] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Revised: 08/16/2019] [Accepted: 08/25/2019] [Indexed: 11/30/2022]
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16
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St-Louis JD, Cervantes-Salazar J, Palacios-Macedo A, Bolio-Cerdán A, Kurosawa H, Jonas RA, Sandoval N, O'Brien J, Tchervenkov CI, Jacobs JP, Kirklin JK. The world database for pediatric and congenital heart surgery: A collaboration with the Registro Nacional de Cirugía Cardiaca Pediátrica. Arch Cardiol Mex 2019; 89:100-104. [PMID: 31702729 DOI: 10.24875/acme.m19000031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Objective Following the notable work accomplished by the Mexican Association of Specialists in Congenital Heart Disease (Asociación Mexicana de Especialistas en Cardiopatías Congénitas) with the development of a national registry for congenital cardiac surgery, the World Society for Pediatric and Congenital Heart Surgery has implemented an international platform to collect data and analyze outcomes of children with congenital heart disease. Methodology This manuscript proposes a possible collaboration between Mexico's national congenital cardiac database (Registro Nacional de Cirugía Cardíaca Pediátrica) and the World Database for Pediatric and Congenital Heart Surgery. Conclusion Such a partnership would advance the countries' desire for the ongoing development of quality improvement processes and improve the overall treatment of children with congenital heart disease.
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Affiliation(s)
- James D St-Louis
- Department of Surgery, University of Missouri-Kansas City School of Medicine, Kansas City, Missouri, USA
| | - Jorge Cervantes-Salazar
- Department of Pediatric Cardiac and Congenital Heart Disease Surgery, Instituto Nacional de Cardiología Ignacio Chávez. Mexico City, Mexico
| | - Alexis Palacios-Macedo
- Department of Cardiac Surgery, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán. Mexico City, Mexico
| | - Alejandro Bolio-Cerdán
- Department of Cardiac Surgery, Hospital Infantil de México Federico Gómez. Mexico City, Mexico
| | - Hiromi Kurosawa
- Department of Cardiovascular Surgery, Heart Institute of Japan, Tokyo Women's Medical University, Tokyo, Japan
| | | | - Nestor Sandoval
- Department of Cardiovascular Surgery, Instituto de Cardiopatías Congénitas, Fundación Cardioinfantil - IC, Bogotá, Colombia
| | - James O'Brien
- Department of Surgery, University of Missouri-Kansas City School of Medicine, Kansas City, Missouri, USA
| | - Christo I Tchervenkov
- Division of Pediatric Cardiovascular Surgery, The Montreal Children's Hospital of the McGill University Health Centre, Montreal, Quebec, Canada
| | - Jeffery P Jacobs
- Department of Surgery, Johns Hopkins All Children's Heart Institute, Johns Hopkins All Children's Hospital and Florida Hospital for Children, Saint Petersburg, Tampa, and Orlando, Florida, USA
| | - James K Kirklin
- Department of Cardiovascular Surgery, University of Alabama at Birmingham, Birmingham, Alabama, USA
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17
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St-Louis JD, Cervantes-Salazar J, Palacios-Macedo A, Bolio-Cerdán A, Kurosawa H, Jonas RA, Sandoval N, O'Brien-Jr J, Tchervenkov CI, Jacobs JP, Kirklin JK. The world database for pediatric and congenital heart surgery: A collaboration with the Registro Nacional de Cirugía Cardiaca Pediátrica. Arch Cardiol Mex 2019; 89:112-116. [PMID: 31314005 DOI: 10.24875/acm.m19000027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Objective Following the notable work accomplished by the Mexican Association of Specialists in Congenital Heart Disease (Asociación Mexicana de Especialistas en Cardiopatías Congénitas) with the development of a national registry for congenital cardiac surgery, the World Society for Pediatric and Congenital Heart Surgery has implemented an international platform to collect data and analyze outcomes of children with congenital heart disease. Methodology This manuscript proposes a possible collaboration between Mexico's national congenital cardiac database (Registro Nacional de Cirugía Cardíaca Pediátrica) and the World Database for Pediatric and Congenital Heart Surgery. Conclusion Such a partnership would advance the countries' desire for the ongoing development of quality improvement processes and improve the overall treatment of children with congenital heart disease.
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Affiliation(s)
- James D St-Louis
- Department of Surgery, University of Missouri-Kansas City School of Medicine, Kansas City, Missouri, USA
| | - Jorge Cervantes-Salazar
- Department of Pediatric Cardiac and Congenital Heart Disease Surgery, Instituto Nacional de Cardiología Ignacio Chávez. Mexico City, Mexico
| | - Alexis Palacios-Macedo
- Department of Cardiac Surgery, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán. Mexico City, Mexico
| | - Alejandro Bolio-Cerdán
- Department of Cardiac Surgery, Hospital Infantil de México Federico Gómez. Mexico City, Mexico
| | - Hiromi Kurosawa
- Department of Cardiovascular Surgery, Heart Institute of Japan, Tokyo Women's Medical University, Tokyo, Japan
| | | | - Nestor Sandoval
- Department of Cardiovascular Surgery, Instituto de Cardiopatías Congénitas, Fundación Cardioinfantil - IC, Bogotá, Colombia
| | - James O'Brien-Jr
- Department of Surgery, University of Missouri-Kansas City School of Medicine, Kansas City, Missouri, USA
| | - Christo I Tchervenkov
- Division of Pediatric Cardiovascular Surgery, The Montreal Children's Hospital of the McGill University Health Centre, Montreal, Quebec, Canada
| | - Jeffery P Jacobs
- Department of Surgery, Johns Hopkins All Children's Heart Institute, Johns Hopkins All Children's Hospital and Florida Hospital for Children, Saint Petersburg, Tampa, and Orlando, Florida, USA
| | - James K Kirklin
- Department of Cardiovascular Surgery, University of Alabama at Birmingham, Birmingham, Alabama, USA
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18
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St Louis JD, Tchervenkov CI, Jonas RA, Sandoval N, Zhang H, Jacobs JP, Talwar S, Halees ZA, Finucane K, Kirklin JK. Proceedings From the 3rd Symposium of the World Database for Pediatric and Congenital Heart Surgery. World J Pediatr Congenit Heart Surg 2019; 10:492-498. [PMID: 31307301 DOI: 10.1177/2150135119852320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The World Database for Pediatric and Congenital Heart Surgery was created to provide a resource for centers to be able to perform complex outcomes analyses of children undergoing repair of a congenital heart defect. In just under two years, the World Society for Pediatric and Congenital Heart Surgery (WSPCHS) has amassed over 13,000 procedures from 55 centers into the database. This Proceedings of the 3rd World Database Symposium held at the 6th Scientific Meeting of the WSPCHS summarizes the presentations of international experts in the fields of outcomes analysis and care of children with congenital heart surgery.
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Affiliation(s)
- James D St Louis
- 1 Division of Cardiac Surgery, Children's Mercy-Kansas City, Kansas City, MO, USA
| | - Christo I Tchervenkov
- 2 Division of Pediatric Cardiovascular Surgery, The Montreal Children's Hospital of the McGill University Health Centre, Montreal, Quebec, Canada
| | - Richard A Jonas
- 3 Department of Cardiovascular Surgery, Children's National Medical Center, Washington, DC, USA
| | - Nestor Sandoval
- 4 Instituto de Cardiopatías Congénitas, Fundacion Cardioinfantil-Insituto de Cardiologia, Universidad del Rosario, Bogotá, Colombia
| | - Hao Zhang
- 5 Department of Cardiothoracic Surgery, Heart Center, Shanghai Children's Medical Center, National Center for Children Health, Shanghai, China
| | - Jeffrey P Jacobs
- 6 Division of Cardiovascular Surgery, Johns Hopkins All Children's Heart Institute, Johns Hopkins All Children's Hospital and Florida Hospital for Children, John Hopkins University, Saint Petersburg, Tampa, Orlando, FL, USA
| | - Sachin Talwar
- 7 All India Institute of Medical Sciences, New Delhi, India
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Jegatheeswaran A, Jacobs ML, Caldarone CA, Kirshbom PM, Williams WG, Blackstone EH, DeCampli WM, Duncan KF, Lambert LM, Walters HL, Tchervenkov CI, McCrindle BW. Self-reported functional health status following interrupted aortic arch repair: A Congenital Heart Surgeons' Society Study. J Thorac Cardiovasc Surg 2019; 157:1577-1587.e10. [PMID: 30770109 DOI: 10.1016/j.jtcvs.2018.11.152] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Revised: 10/15/2018] [Accepted: 11/11/2018] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Improved survival after congenital heart surgery has led to interest in functional health status. We sought to identify factors associated with self-reported functional health status in adolescents and young adults with repaired interrupted aortic arch. METHODS Follow-up of survivors (aged 13-24 years) from a 1987 to 1997 inception cohort of neonates included completion of functional health status questionnaires (Child Health Questionnaire-CF87 [age <18 years, n = 51] or the Short Form [SF]-36 [age ≥18 years, n = 66]) and another about 22q11 deletion syndrome (22q11DS) features (n = 141). Factors associated with functional health status domains were determined using multivariable linear regression analysis. RESULTS Domain scores of respondents were significantly greater than norms in 2 of 9 Child Health Questionnaire-CF87 and 4 of 10 SF-36 domains and only lower in the physical functioning domain of the SF-36. Factors most commonly associated with lower scores included those suggestive of 22q11DS (low calcium levels, recurrent childhood infections, genetic testing/diagnosis, abnormal facial features, hearing deficits), the presence of self-reported behavioral and mental health problems, and a greater number of procedures. Factors explained between 10% and 70% of domain score variability (R2 = 0.10-0.70, adj-R2 = 0.09-0.66). Of note, morphology and repair type had a minor contribution. CONCLUSIONS Morbidities associated with 22q11DS, psychosocial issues, and recurrent medical issues affect functional health status more than initial morphology and repair in this population. Nonetheless, these patients largely perceive themselves as better than their peers. This demonstrates the chronic nature of interrupted aortic arch and suggests the need for strategies to decrease reinterventions and for evaluation of mental health and genetic issues to manage associated deteriorations.
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Affiliation(s)
- Anusha Jegatheeswaran
- Division of Cardiac Surgery, Department of Surgery, University of Toronto, Hospital for Sick Children, Toronto, Ontario, Canada.
| | - Marshall L Jacobs
- Division of Cardiac Surgery, Department of Surgery, Johns Hopkins University, Baltimore, Md
| | - Christopher A Caldarone
- Division of Cardiac Surgery, Department of Surgery, University of Toronto, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Paul M Kirshbom
- Division of Cardiothoracic Surgery, Department of Surgery, Levine Children's Hospital, Charlotte, NC
| | - William G Williams
- Division of Cardiac Surgery, Department of Surgery, University of Toronto, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Eugene H Blackstone
- Department of Thoracic and Cardiovascular Surgery, Lerner Research Institute, Cleveland Clinic Foundation, Cleveland, Ohio
| | - William M DeCampli
- Division of Cardiac Surgery, Department of Surgery, University of Central Florida College of Medicine, Arnold Palmer Hospital for Children, Orlando, Fla
| | - Kim F Duncan
- Division of Cardiothoracic Surgery, Department of Surgery, University of Nebraska Medical Center, Omaha, Neb
| | - Linda M Lambert
- Division of Cardiothoracic Surgery, Department of Surgery, University of Utah, Primary Children's Hospital, Salt Lake City, Utah
| | - Henry L Walters
- Division of Cardiovascular Surgery, Department of Surgery, Wayne State University, Children's Hospital of Michigan, Detroit, Mich
| | - Christo I Tchervenkov
- Division of Pediatric Cardiac Surgery, Department of Surgery, McGill University, Montreal Children's Hospital, Montreal, Québec, Canada
| | - Brian W McCrindle
- Department of Pediatrics, Division of Cardiology, University of Toronto, Hospital for Sick Children, Toronto, Ontario, Canada
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St Louis JD, Timkovich N, Lenderman S, Jonas RA, Guleserian KJ, Tchervenkov CI, Jacobs JP, Austin EH, Plunkett MD, Myers JL, Hraska V, Sinha P, O'Brien JE, Jacobs ML, Kirklin JK. The World Database for Pediatric and Congenital Heart Surgery "A Call to Service for North American Congenital Heart Surgery Programs". Semin Thorac Cardiovasc Surg 2019; 31:230-233. [PMID: 30616005 DOI: 10.1053/j.semtcvs.2019.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2018] [Accepted: 01/02/2019] [Indexed: 11/11/2022]
Abstract
The World Society for Pediatric and Congenital Heart Surgery has endorsed the establishment of an international platform for the exchange of knowledge and experience for those that treat patients with a congenital heart defect. On January 1, 2017, the release of the World Database for Pediatric and Congenital Heart Surgery opened a new era in evaluation of treatment with congenital heart defects. The contribution of data from countries with established congenital surgical databases will greatly enhance the efforts to provide the most accurate measure of overall surgical outcomes across the globe.
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Affiliation(s)
- James D St Louis
- Department of Surgery, University of Missouri-Kansas City School of Medicine, Kansas City, Missouri.
| | - Nick Timkovich
- University of Alabama at Birmingham, Birmingham, Alabama
| | | | - Richard A Jonas
- Department of Cardiovascular Surgery, Children's National Medical Center, Washington DC
| | | | - Christo I Tchervenkov
- Division of Pediatric Cardiovascular Surgery, The Montreal Children's Hospital of the McGill University Health Centre, Montreal, Quebec, Canada
| | - Jeffery P Jacobs
- Division of Cardiovascular of Surgery, Johns Hopkins All Children's Heart Institute, Johns Hopkins All Children's Hospital and Florida Hospital for Children, John Hopkins University, Saint Petersburg, Tampa, and Orlando, Florida
| | - Erle H Austin
- University of Louisville, Norton Children's Hospital, Louisville, Kentucky
| | - Mark D Plunkett
- Congenital Heart Center at Children's Hospital of Illinois, Peoria, Illinois
| | - John L Myers
- Penn State Children's Hospital, Hershey, Pennsylvania
| | - Viktor Hraska
- Herma Heart Institute, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Pranava Sinha
- Department of Cardiovascular Surgery, Children's National Medical Center, Washington DC
| | - James E O'Brien
- Department of Surgery, University of Missouri-Kansas City School of Medicine, Kansas City, Missouri
| | - Marshall L Jacobs
- Division of Cardiac Surgery, Johns Hopkins University, Baltimore, Maryland
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Jacobs JP, Tchervenkov CI, Stellin G, Kurosawa H, Mavroudis C, Jatene MB, Al-Halees Z, Cicek SM, Sandoval NF, Backer CL, Cervantes J, Dearani JA, Ebels T, Edwin F, Finucane K, Fragata J, Iyer KS, Kinsley RH, Kirklin JK, Kreutzer C, Liu J, Maruszewski B, St Louis JD, Sarris GE, Jonas RA. History of the World Society for Pediatric and Congenital Heart Surgery: The First Decade. World J Pediatr Congenit Heart Surg 2018; 9:392-406. [PMID: 29945512 DOI: 10.1177/2150135118775962] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The World Society for Pediatric and Congenital Heart Surgery (WSPCHS) is the largest professional organization in the world dedicated to pediatric and congenital heart surgery. The purpose of this article is to document the first decade of the history of WSPCHS from its formation in 2006, to summarize the current status of WSPCHS, and to consider the future of WSPCHS. The WSPCHS was incorporated in Canada on April 7, 2011, with a head office in Montreal, Canada. The vision of the WSPCHS is that every child born anywhere in the world with a congenital heart defect should have access to appropriate medical and surgical care. The mission of the WSPCHS is to promote the highest quality comprehensive cardiac care to all patients with congenital heart disease, from the fetus to the adult, regardless of the patient's economic means, with an emphasis on excellence in teaching, research, and community service.
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Affiliation(s)
- Jeffrey P Jacobs
- 1 Division of Cardiac Surgery, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.,2 Division of Cardiovascular Surgery, Department of Surgery, Johns Hopkins All Children's Heart Institute, Johns Hopkins All Children's Hospital and Florida Hospital for Children, St Petersburg, Tampa, and Orlando, FL, USA
| | - Christo I Tchervenkov
- 3 Division of Pediatric Cardiovascular Surgery, The Montreal Children's Hospital of the McGill University Health Centre, Montreal, Quebec, Canada
| | - Giovanni Stellin
- 4 Pediatric and Congenital Cardiac Surgical Unit, University of Padova Medical School, Padova, Italy
| | - Hiromi Kurosawa
- 5 Cardiovascular Surgery, Heart Institute of Japan, Tokyo Women's Medical University, Tokyo, Japan
| | - Constantine Mavroudis
- 1 Division of Cardiac Surgery, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.,2 Division of Cardiovascular Surgery, Department of Surgery, Johns Hopkins All Children's Heart Institute, Johns Hopkins All Children's Hospital and Florida Hospital for Children, St Petersburg, Tampa, and Orlando, FL, USA
| | - Marcelo B Jatene
- 6 Department of Pediatric Cardiac Surgery and Pediatric Cardiology, Heart Institute, University of São Paulo Medical School, São Paulo, Brazil
| | - Zohair Al-Halees
- 7 Heart Centre, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Sertac M Cicek
- 8 Department of Cardiovascular Surgery, Mayo Clinic, Rochester, MN, USA
| | - Nestor F Sandoval
- 9 Instituto de Cardiopatías Congénitas, Fundación Cardioinfantil-IC, Universidad del Rosario, Bogota, Colombia
| | - Carl L Backer
- 10 Northwestern University Feinberg School of Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, CA, USA
| | - Jorge Cervantes
- 11 Department of Cardiac Surgery and Congenital Heart Diseases, Instituto Nacional de Cardiologıa "Ignacio Chavez" (National Institute of Cardiology "Ignacio Chavez"), Mexico City, Mexico
| | | | - Tjark Ebels
- 13 Academic Medical Centre, University of Amsterdam, Amsterdam, the Netherlands
| | - Frank Edwin
- 14 National Cardiothoracic Center, Korle Bu Teaching Hospital, Accra, Ghana.,15 Department of Surgery, University of Health and Allied Sciences, Ho, Ghana
| | - Kirsten Finucane
- 16 Green Lane Paediatric and Congenital Cardiac Services, Starship Children's Hospital, Auckland, New Zealand
| | - Jose Fragata
- 17 Hospital de Santa Marta, NOVA Medical School, Lisbon, Portugal
| | - Krishna S Iyer
- 18 Fortis Escorts Heart Institute and Research Centre, New Delhi, Delhi, India
| | - Robin H Kinsley
- 19 The Paediatric Cardiac Centre for Africa, Sunninghill Hospital, Johannesburg, South Africa
| | | | - Christian Kreutzer
- 21 Division of Congenital Heart Surgery, Hospital Privado Universitario de Córdoba, Córdoba, Argentina
| | - Jinfen Liu
- 22 Department of Pediatric Thoracic and Cardiovascular Surgery, Xinhua Hospital, Shanghai Children's Medical Center, Shanghai Second Medical University, Shanghai, China
| | - Bohdan Maruszewski
- 23 Department of Pediatric and Congenital Heart Surgery, Children's Memorial Health Institute, Warsaw, Poland
| | - James D St Louis
- 24 Department of Surgery, University of Missouri-Kansas City School of Medicine, Kansas City, MI, USA
| | - George E Sarris
- 25 Athens Heart Surgery Institute and Department of Pediatric, Congenital Heart Surgery at IASO Children's Hospital, Athens, Greece
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St Louis JD, Lee C, Kurosawa H, Jonas RA, Kisaburo S, Tchervenkov CI, Jacobs JP, Kirklin JK. The World Database for Pediatric and Congenital Heart Surgery: Use of an International Congenital Database in South Korea. Korean J Thorac Cardiovasc Surg 2018; 51:81-84. [PMID: 29430436 PMCID: PMC5796625 DOI: 10.5090/kjtcs.2018.51.1.81] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Revised: 08/16/2017] [Accepted: 08/16/2017] [Indexed: 11/16/2022]
Affiliation(s)
- James D St Louis
- Department of Surgery, University of Missouri-Kansas City School of Medicine, The Catholic University of Korea
| | - Cheul Lee
- Department of Thoracic and Cardiovascular Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea
| | - Hiromi Kurosawa
- Department of Cardiovascular Surgery, Heart Institute of Japan, Tokyo Women's Medical University
| | - Richard A Jonas
- Department of Cardiac Surgery, Children's National Health System
| | - Sakamoto Kisaburo
- Department of Cardiovascular Surgery, Mt Fuji Shizuoka Children's Hospital
| | - Christo I Tchervenkov
- Division of Pediatric Cardiovascular Surgery, The Montreal Children's Hospital of the McGill University Health Centre
| | - Jeffery P Jacobs
- Division of Cardiovascular of Surgery, Johns Hopkins All Children's Heart Institute, Johns Hopkins All Children's Hospital and Florida Hospital for Children, Johns Hopkins University
| | - James K Kirklin
- Division of Cardiothoracic Surgery, University of Alabama at Birmingham
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Tchervenkov CI, Jonas RA, Jacobs ML. A Warm Welcome to Respected Colleagues. World J Pediatr Congenit Heart Surg 2018; 9:9. [PMID: 29310553 DOI: 10.1177/2150135117750458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Christo I Tchervenkov
- 1 Division of Pediatric Cardiovascular Surgery, Montreal Children's Hospital, McGill University Health Center, Quebec, Canada
| | - Richard A Jonas
- 2 Department of Cardiovascular Surgery, Children's National Health System, Washington, DC,, USA
| | - Marshall L Jacobs
- 3 Division of Cardiac Surgery, The Johns Hopkins Hospital, Baltimore, MD, USA
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St. Louis JD, Kurosawa H, Jonas RA, Sandoval N, Cervantes J, Tchervenkov CI, Jacobs JP, Sakamoto K, Stellin G, Kirklin JK. The World Database for Pediatric and Congenital Heart Surgery: The Dawn of a New Era of Global Communication and Quality Improvement in Congenital Heart Disease. World J Pediatr Congenit Heart Surg 2017; 8:597-599. [DOI: 10.1177/2150135117725458] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The World Society for Pediatric and Congenital Heart Surgery was founded with the mission to “promote the highest quality comprehensive cardiac care to all patients with congenital heart disease, from the fetus to the adult, regardless of the patient’s economic means, with an emphasis on excellence in teaching, research, and community service.” Early on, the Society’s members realized that a crucial step in meeting this goal was to establish a global database that would collect vital information, allowing cardiac surgical centers worldwide to benchmark their outcomes and improve the quality of congenital heart disease care. With tireless efforts from all corners of the globe and utilizing the vast experience and invaluable input of multiple international experts, such a platform of global information exchange was created: The World Database for Pediatric and Congenital Heart Disease went live on January 1, 2017. This database has been thoughtfully designed to produce meaningful performance and quality analyses of surgical outcomes extending beyond immediate hospital survival, allowing capture of important morbidities and mortalities for up to 1 year postoperatively. In order to advance the societal mission, this quality improvement program is available free of charge to WSPCHS members. In establishing the World Database, the Society has taken an essential step to further the process of global improvement in care for children with congenital heart disease.
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Affiliation(s)
- James D. St. Louis
- Department of Surgery, School of Medicine, University of Missouri–Kansas City, Kansas City, MO, USA
| | - Hiromi Kurosawa
- Cardiovascular Surgery, Heart Institute of Japan, Tokyo Women’s Medical University, Tokyo, Japan
| | | | - Nestor Sandoval
- Instituto de Cardiopatías Congénitas, Fundacion Cardioinfantil—IC, Bogota, Colombia
| | | | - Christo I. Tchervenkov
- Division of Pediatric Cardiovascular Surgery, The Montreal Children’s Hospital of the McGill University Health Centre, Montreal, Quebec, Canada
| | - Jeffery P. Jacobs
- Division of Cardiovascular of Surgery, Johns Hopkins All Children’s Heart Institute, Johns Hopkins All Children’s Hospital and Florida Hospital for Children, John Hopkins University, Saint Petersburg, Tampa, and Orlando, FL, USA
| | - Kisaburo Sakamoto
- Department of Cardiovascular Surgery, Mt Fuji Shizuoka Children’s Hospital, Japan
| | - Giovanni Stellin
- Pediatric and Congenital Cardiac Surgical Unit—University of Padova Medical School, Padova, Italy
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Jacobs JP, Mayer JE, Mavroudis C, O’Brien SM, Austin EH, Pasquali SK, Hill KD, Overman DM, St. Louis JD, Karamlou T, Pizarro C, Hirsch-Romano JC, McDonald D, Han JM, Becker S, Tchervenkov CI, Lacour-Gayet F, Backer CL, Fraser CD, Tweddell JS, Elliott MJ, Walters H, Jonas RA, Prager RL, Shahian DM, Jacobs ML. The Society of Thoracic Surgeons Congenital Heart Surgery Database: 2017 Update on Outcomes and Quality. Ann Thorac Surg 2017; 103:699-709. [DOI: 10.1016/j.athoracsur.2017.01.004] [Citation(s) in RCA: 65] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Revised: 01/08/2017] [Accepted: 01/10/2017] [Indexed: 11/16/2022]
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Wilder TJ, McCrindle BW, Hickey EJ, Ziemer G, Tchervenkov CI, Jacobs ML, Gruber PJ, Blackstone EH, Williams WG, DeCampli WM, Caldarone CA, Pizarro C. Is a hybrid strategy a lower-risk alternative to stage 1 Norwood operation? J Thorac Cardiovasc Surg 2016; 153:163-172.e6. [PMID: 27671550 DOI: 10.1016/j.jtcvs.2016.08.021] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2016] [Revised: 07/17/2016] [Accepted: 08/06/2016] [Indexed: 11/19/2022]
Abstract
BACKGROUND For neonates with critical left ventricular outflow tract obstruction (LVOTO), hybrid procedures are an alternative to the Norwood stage 1 procedure. Despite perceived advantages, however, outcomes are not well defined. Therefore, we compared outcomes after stage 1 hybrid and Norwood procedures. METHODS In a critical LVOTO inception cohort (2005-2014; 20 institutions), a total of 564 neonates underwent stage 1 palliation with the Norwood operation with a modified Blalock-Taussig shunt (NW-BT; n = 232; 41%), Norwood operation with a right ventricle-to-pulmonary artery conduit (NW-RVPA; n = 222; 39%), or a hybrid procedure (n = 110; 20%). Post-stage 1 outcomes were analyzed via competing-risks and parametric hazard analyses and compared among all 564 patients and between patients who underwent propensity-matched hybrid and those who underwent NW-BT/NW-RVPA. RESULTS By 6 years after the stage 1 operation, 50% ± 3%, 7% ± 2%, and 4% ± 1% of patients transitioned to Fontan, transplantation, and biventricular repair, respectively, whereas 7% ± 2% were alive without transition and 32% ± 2% died. Risk factors for death without transition included procedure type, smaller ascending aorta, aortic valve atresia, and lower birth weight. Risk-adjusted 4-year survival was better after NW-RVPA than after NW-BT or hybrid (76% vs 60% vs 61%; P < .001). Furthermore, for neonates with lower birth weight (<∼2 kg), an interaction between birth weight and hybrid resulted in a trend toward better survival after hybrid compared with NW-BT or NW-RVPA. For propensity-matched neonates between hybrid and NW-BT (88 pairs), 4-year survival was similar (62% vs 57%; P = .58). For propensity-matched neonates between hybrid and NW-RVPA (81 pairs), 4-year survival was better after NW-RVPA (59% vs 75%; P = .008). CONCLUSIONS For neonates with critical LVOTO undergoing single-ventricle palliation, NW-RVPA was associated with the best overall survival. Hybrid strategies are not a lower-risk alternative to Norwood operations overall; however, the impact of lower birth weight on survival may be mitigated after hybrid procedures compared with Norwood operations.
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Affiliation(s)
- Travis J Wilder
- Congenital Heart Surgeons' Society Data Center, University of Toronto, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Brian W McCrindle
- Division of Pediatric Cardiology, Department of Pediatrics, University of Toronto, The Hospital for Sick Children, Toronto, Ontario, Canada.
| | - Edward J Hickey
- Department of Cardiovascular Surgery, University of Toronto, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Gerhard Ziemer
- Division of Cardiac and Thoracic Surgery, Department of Surgery, University of Chicago Medicine, Chicago, Ill
| | - Christo I Tchervenkov
- Department of Cardiothoracic Surgery, Montreal Children's Hospital of the McGill University Health Center, Montreal, Quebec, Canada
| | - Marshall L Jacobs
- Department of Surgery, Johns Hopkins School of Medicine, Baltimore, Md
| | - Peter J Gruber
- Division of Cardiothoracic Surgery, Department of Surgery, University of Iowa Carver College of Medicine, Iowa City, Iowa
| | | | - William G Williams
- Congenital Heart Surgeons' Society Data Center, University of Toronto, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - William M DeCampli
- Department of Cardiothoracic Surgery, Arnold Palmer Hospital for Children, Orlando, Fla
| | - Christopher A Caldarone
- Department of Cardiovascular Surgery, University of Toronto, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Christian Pizarro
- Nemours Cardiac Center, Alfred I. DuPont Hospital for Children, Wilmington, Del
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Morales DLS, Khan MS, Turek JW, Biniwale R, Tchervenkov CI, Rush M, Jacobs JP, Tweddell JS, Jacobs ML. Report of the 2015 Society of Thoracic Surgeons Congenital Heart Surgery Practice Survey. Ann Thorac Surg 2016; 103:622-628. [PMID: 27553498 DOI: 10.1016/j.athoracsur.2016.05.108] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2016] [Revised: 05/17/2016] [Accepted: 05/24/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND The Society of Thoracic Surgeons Workforce on Congenital Heart Surgery (CHS) undertook a third subspecialty Practice Survey (2005, 2010, 2015) to obtain contemporary data. METHODS A search for potential participants was conducted using multiple directories and websites. The survey instrument was widely distributed electronically. All surgeons listing congenital or pediatric cardiac surgery among interests were targeted. RESULTS There were a total of 213 respondents: 177 (83%) were practicing congenital heart surgeons (median age 50 years; range, 34 to 80 years; 93% men), 9 (4%) were CHS trainees, 17 (8%) were retired congenital heart surgeons, and 10 (5%) were others. For practicing surgeons, mean duration of postgraduate training was 10 ± 2 years and 151 (85%) were CHS-board certified. Median practice duration for congenital heart surgeons was 15 years (less than 1 to 42 years). Work hours per week were greater than 70 for 74 (42%) surgeons, 103 (58%) work at a freestanding children's hospital, and 113 (64%) have full academic appointments. Caseload for 47 (27%) surgeons was less than 100 cases/year and 42 (24%) performed greater than 200 cases/year. For practicing surgeons, anticipated median retirement age was 66 years (range, 55 to 83 years), 31 (18%) estimated ≤5 years to retirement, and 163 (92%) were extremely or very satisfied in their career. CONCLUSIONS These data provide contemporary insights regarding the CHS workforce in North America and should help facilitate rational plans to address the needs of an expanding patient population.
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Affiliation(s)
- David L S Morales
- Department of Pediatric Cardiothoracic Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
| | - Muhammad S Khan
- Department of Family Medicine, School of Community Medicine University of Oklahoma, Tulsa, Oklahoma
| | - Joseph W Turek
- Department of Cardiothoracic Surgery, University of Iowa, Iowa City, Iowa
| | - Reshma Biniwale
- Department of Surgery, University of California Los Angeles, Los Angeles, California
| | - Christo I Tchervenkov
- Division of Pediatric Cardiovascular Surgery, Montreal Children's Hospital, McGill University Health Center, Montreal, Quebec, Canada
| | - Michele Rush
- The Society of Thoracic Surgeons, Chicago, Illinois
| | - Jeffrey P Jacobs
- Department of Cardiovascular Surgery, Johns Hopkins All Children's Heart Institute, St. Petersburg, Florida
| | - James S Tweddell
- Department of Pediatric Cardiothoracic Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Marshall L Jacobs
- Division of Cardiac Surgery, Johns Hopkins University, Baltimore, Maryland
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Jacobs JP, Mayer JE, Mavroudis C, O'Brien SM, Austin EH, Pasquali SK, Hill KD, He X, Overman DM, St Louis JD, Karamlou T, Pizarro C, Hirsch-Romano JC, McDonald D, Han JM, Dokholyan RS, Tchervenkov CI, Lacour-Gayet F, Backer CL, Fraser CD, Tweddell JS, Elliott MJ, Walters H, Jonas RA, Prager RL, Shahian DM, Jacobs ML. The Society of Thoracic Surgeons Congenital Heart Surgery Database: 2016 Update on Outcomes and Quality. Ann Thorac Surg 2016; 101:850-62. [PMID: 26897186 DOI: 10.1016/j.athoracsur.2016.01.057] [Citation(s) in RCA: 67] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2015] [Revised: 01/09/2016] [Accepted: 01/12/2016] [Indexed: 11/19/2022]
Abstract
The Society of Thoracic Surgeons Congenital Heart Surgery Database is the largest congenital and pediatric cardiac surgical clinical data registry in the world. It is the platform for all activities of The Society of Thoracic Surgeons related to the analysis of outcomes and the improvement of quality in this subspecialty. This article summarizes current aggregate national outcomes in congenital and pediatric cardiac surgery and reviews related activities in the areas of quality measurement, performance improvement, and transparency. The reported data about aggregate national outcomes are exemplified by an analysis of 10 benchmark operations performed from January 2011 to December 2014 and documenting overall discharge mortality (interquartile range among programs with more than 9 cases): off-bypass coarctation, 1.0% (0.0% to 0.9%); ventricular septal defect repair, 0.7% (0.0% to 1.1%); tetralogy of Fallot repair, 1.0% (0.0% to 1.7%); complete atrioventricular canal repair, 3.2% (0.0% to 6.5%); arterial switch operation, 2.7% (0.0% to 5.6%); arterial switch operation plus ventricular septal defect, 5.3% (0.0% to 6.7%); Glenn/hemiFontan, 2.1% (0.0% to 3.8%); Fontan operation, 1.4% (0.0% to 2.4%); truncus arteriosus repair, 9.6% (0.0 % to 11.8%); and Norwood procedure, 15.6% (10.0% to 21.4%).
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Affiliation(s)
- Jeffrey P Jacobs
- Division of Cardiac Surgery, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland; Division of Cardiovascular Surgery, Department of Surgery, Johns Hopkins All Children's Heart Institute, All Children's Hospital and Florida Hospital for Children, Saint Petersburg, Tampa, and Orlando, Florida.
| | - John E Mayer
- Children's Hospital Boston, Harvard Medical School, Boston, Massachusetts
| | - Constantine Mavroudis
- Division of Cardiac Surgery, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland; Division of Cardiovascular Surgery, Department of Surgery, Johns Hopkins All Children's Heart Institute, All Children's Hospital and Florida Hospital for Children, Saint Petersburg, Tampa, and Orlando, Florida
| | | | - Erle H Austin
- Kosair Children's Hospital, University of Louisville, Louisville, Kentucky
| | - Sara K Pasquali
- C. S. Mott Children's Hospital, University of Michigan, Ann Arbor, Michigan
| | | | - Xia He
- Duke University, Durham, North Carolina
| | - David M Overman
- The Children's Heart Clinic at Children's Hospitals and Clinics of Minnesota, Minneapolis, Minnesota
| | - James D St Louis
- Department of Surgery, University of Missouri-Kansas City School of Medicine, Kansas City, Missouri
| | - Tara Karamlou
- Division of Pediatric Cardiac Surgery, Benioff Children's Hospital, University of California, San Francisco, San Francisco, California
| | | | | | | | - Jane M Han
- The Society of Thoracic Surgeons, Chicago, Illinois
| | | | | | | | - Carl L Backer
- Northwestern University Feinberg School of Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois
| | - Charles D Fraser
- Texas Children's Hospital, Baylor College of Medicine, Houston, Texas
| | - James S Tweddell
- Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Martin J Elliott
- The Great Ormond Street Hospital, London, England, United Kingdom
| | - Hal Walters
- Children's Hospital of Michigan, Wayne State University School of Medicine, Detroit, Michigan
| | | | | | - David M Shahian
- Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Marshall L Jacobs
- Division of Cardiac Surgery, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland; Division of Cardiovascular Surgery, Department of Surgery, Johns Hopkins All Children's Heart Institute, All Children's Hospital and Florida Hospital for Children, Saint Petersburg, Tampa, and Orlando, Florida
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Jacobs JP, O'Brien SM, Pasquali SK, Gaynor JW, Mayer JE, Karamlou T, Welke KF, Filardo G, Han JM, Kim S, Quintessenza JA, Pizarro C, Tchervenkov CI, Lacour-Gayet F, Mavroudis C, Backer CL, Austin EH, Fraser CD, Tweddell JS, Jonas RA, Edwards FH, Grover FL, Prager RL, Shahian DM, Jacobs ML. The Society of Thoracic Surgeons Congenital Heart Surgery Database Mortality Risk Model: Part 2-Clinical Application. Ann Thorac Surg 2015; 100:1063-8; discussion 1068-70. [PMID: 26245504 DOI: 10.1016/j.athoracsur.2015.07.011] [Citation(s) in RCA: 114] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2014] [Revised: 04/24/2015] [Accepted: 07/02/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND The empirically derived 2014 Society of Thoracic Surgeons Congenital Heart Surgery Database Mortality Risk Model incorporates adjustment for procedure type and patient-specific factors. The purpose of this report is to describe this model and its application in the assessment of variation in outcomes across centers. METHODS All index cardiac operations in The Society of Thoracic Surgeons Congenital Heart Surgery Database (January 1, 2010, to December 31, 2013) were eligible for inclusion. Isolated patent ductus arteriosus closures in patients weighing less than or equal to 2.5 kg were excluded, as were centers with more than 10% missing data and patients with missing data for key variables. The model includes the following covariates: primary procedure, age, any prior cardiovascular operation, any noncardiac abnormality, any chromosomal abnormality or syndrome, important preoperative factors (mechanical circulatory support, shock persisting at time of operation, mechanical ventilation, renal failure requiring dialysis or renal dysfunction (or both), and neurological deficit), any other preoperative factor, prematurity (neonates and infants), and weight (neonates and infants). Variation across centers was assessed. Centers for which the 95% confidence interval for the observed-to-expected mortality ratio does not include unity are identified as lower-performing or higher-performing programs with respect to operative mortality. RESULTS Included were 52,224 operations from 86 centers. Overall discharge mortality was 3.7% (1,931 of 52,224). Discharge mortality by age category was neonates, 10.1% (1,129 of 11,144); infants, 3.0% (564 of 18,554), children, 0.9% (167 of 18,407), and adults, 1.7% (71 of 4,119). For all patients, 12 of 86 centers (14%) were lower-performing programs, 67 (78%) were not outliers, and 7 (8%) were higher-performing programs. CONCLUSIONS The 2014 Society of Thoracic Surgeons Congenital Heart Surgery Database Mortality Risk Model facilitates description of outcomes (mortality) adjusted for procedural and for patient-level factors. Identification of low-performing and high-performing programs may be useful in facilitating quality improvement efforts.
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Affiliation(s)
- Jeffrey P Jacobs
- Johns Hopkins All Children's Heart Institute, Saint Petersburg, Tampa, and Orlando, Florida; Division of Cardiac Surgery, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland; Florida Hospital for Children, Orlando, Florida.
| | - Sean M O'Brien
- Duke Clinical Research Institute, Duke University School of Medicine, Durham, North Carolina
| | - Sara K Pasquali
- Department of Pediatrics and Communicable Diseases, C.S. Mott Children's Hospital, University of Michigan, Ann Arbor, Michigan
| | - J William Gaynor
- Division of Cardiothoracic Surgery, Department of Surgery, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - John E Mayer
- Department of Cardiac Surgery, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Tara Karamlou
- Division of Pediatric Cardiac Surgery, Benioff Children's Hospital, University of California, San Francisco, San Francisco, California
| | - Karl F Welke
- Section of Congenital Cardiovascular Surgery, University of Illinois College of Medicine at Peoria, Children's Hospital of Illinois, Peoria, Illinois
| | - Giovanni Filardo
- Institute for Health Care Research and Improvement, Baylor Health Care System, Dallas, Texas
| | - Jane M Han
- The Society of Thoracic Surgeons, Chicago, Illinois
| | - Sunghee Kim
- Duke Clinical Research Institute, Duke University School of Medicine, Durham, North Carolina
| | - James A Quintessenza
- Johns Hopkins All Children's Heart Institute, Saint Petersburg, Tampa, and Orlando, Florida; Division of Cardiac Surgery, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland; Florida Hospital for Children, Orlando, Florida
| | | | | | | | - Constantine Mavroudis
- Johns Hopkins All Children's Heart Institute, Saint Petersburg, Tampa, and Orlando, Florida; Division of Cardiac Surgery, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland; Florida Hospital for Children, Orlando, Florida
| | - Carl L Backer
- Northwestern University Feinberg School of Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois
| | - Erle H Austin
- Kosair Children's Hospital, University of Louisville, Louisville, Kentucky
| | - Charles D Fraser
- Texas Children's Hospital, Baylor College of Medicine, Houston, Texas
| | | | | | - Fred H Edwards
- University of Florida, College of Medicine-Jacksonville, Jacksonville, Florida
| | | | | | - David M Shahian
- Massachusetts General Hospital Department of Surgery and Center for Quality and Safety, and Harvard Medical School, Boston, Massachusetts
| | - Marshall L Jacobs
- Johns Hopkins All Children's Heart Institute, Saint Petersburg, Tampa, and Orlando, Florida; Division of Cardiac Surgery, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland; Florida Hospital for Children, Orlando, Florida
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Wilder TJ, Blackstone E, Rajeswaran J, Caldarone C, Gruber PJ, Alsoufi B, Jaquiss R, Tchervenkov CI, Jaggers J, Si MS, Mascio C, Pizarro C, Overman D, Hickey E. TRENDS IN RIGHT VENTRICULAR DYSFUNCTION AND TRICUSPID REGURGITATION AFTER SINGLE VENTRICLE PALLIATION OF HYPOPLASTIC LEFT HEART SYNDROME AND THEIR DIFFERENTIAL IMPACT ON SURVIVAL. J Am Coll Cardiol 2015. [DOI: 10.1016/s0735-1097(15)60504-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Nguyen N, Jacobs JP, Dearani JA, Weinstein S, Novick WM, Jacobs ML, Massey J, Pasquali SK, Walters HL, Drullinsky D, Stellin G, Tchervenkov CI. Survey of nongovernmental organizations providing pediatric cardiovascular care in low- and middle-income countries. World J Pediatr Congenit Heart Surg 2015; 5:248-55. [PMID: 24668973 DOI: 10.1177/2150135113514458] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
BACKGROUND Nearly 90% of the children with heart disease in low- and middle-income countries (LMICs) cannot access cardiovascular (CV) services. Limitations include inadequate financial, human, and infrastructure resources. Nongovernmental organizations (NGOs) have played crucial roles in providing clinical services and infrastructure supports to LMICs CV programs; however, these outreach efforts are dispersed, inadequate, and lack coordination. METHODS A survey was sent to members of the World Society for Pediatric and Congenital Heart Society and PediHeart. RESULTS A clearinghouse was created to provide information on NGO structures, geographic reach, and scope of services. The survey identified 80 NGOs supporting CV programs in 92 LMICs. The largest outreach efforts were in South and Central America (42%), followed by Africa (18%), Europe (17%), Asia (17%), and Asia-Western Pacific (6%). Most NGOs (51%) supported two to five outreach missions per year. The majority (87%) of NGOs provided education, diagnostics, and surgical or catheter-based interventions. Working jointly with LMIC partners, 59% of the NGOs performed operations in children and infants; 41% performed nonbypass neonatal operations. Approximately a quarter (26%) reported that partner sites do not perform interventions in between missions. CONCLUSIONS Disparity and inadequacy in pediatric CV services remain an important problem for LMICs. A global consensus and coordinated efforts are needed to guide strategies on the development of regional centers of excellence, a global outcome database, and a CV program registry. Future efforts should be held accountable for impacts such as growth in the number of independent LMIC programs as well as reduction in mortality and patient waiting lists.
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Affiliation(s)
- Nguyenvu Nguyen
- Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA
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Jacobs ML, Tchervenkov CI. Tribute to a patriarch: Adib Domingos Jatene, 1929-2014. World J Pediatr Congenit Heart Surg 2014; 6:7-8. [PMID: 25548337 DOI: 10.1177/2150135114563550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Marshall L Jacobs
- Department of Surgery, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Christo I Tchervenkov
- Division of Pediatric Cardiovascular Surgery, The Montreal Children's Hospital of the McGill University Health Centre, Montreal, Quebec, Canada
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Poynter JA, Bondarenko I, Austin EH, DeCampli WM, Jacobs JP, Ziemer G, Kirshbom PM, Tchervenkov CI, Karamlou T, Blackstone EH, Walters HL, Gaynor JW, Mery CM, Pearl JM, Brothers JA, Caldarone CA, Williams WG, Jacobs ML, Mavroudis C, DeCampli WM, Fiore AC, Huddleston CB, Weinstein S, Bondarenko I, Walters HL, Moga FX, Morales DL, Blackstone EH, Jacobs JP, Kanter KR, Mavroudis C, Poynter JA, Jacobs ML, Austin EH, Tchervenkov CI, Pearl JM, Gruber PJ, Mainwaring RD, Mery CM, Brothers JA, Gaynor JW, Caldarone CA, McCrindle BW, Wilder TJ, Williams WG, Karamlou T, Ziemer G, St. Louis JD, Ricci M, Kirshbom PM. Repair of Anomalous Aortic Origin of a Coronary Artery in 113 Patients. World J Pediatr Congenit Heart Surg 2014; 5:507-14. [DOI: 10.1177/2150135114540182] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Background: Anomalous aortic origin of a coronary artery (AAOCA) encompasses a wide morphologic spectrum, which has impeded consensus regarding indications for the diverse repair strategies. We constructed a profile of current surgical techniques and explore their application to morphologic variants. Methods: Patients <30 years old (n = 113) with isolated AAOCA who underwent operations at 29 Congenital Heart Surgeons Society (CHSS) institutions from 1998 to 2012 were identified from the CHSS AAOCA Registry. Operative findings were related to surgical techniques at index repairs by cross-tabulation. Results: Anomalous origin of the left main or left anterior descending coronary artery was present in 33 (29%) patients and of the right coronary artery in 78 (69%) patients; 2 arteries originated directly above the commissure between the left and right sinuses. There were 101 (89%) interarterial and intramural (IA/IM) arteries, 10 (9%) were interarterial but not intramural (IA/NIM) and 2 (2%) were neither interarterial nor intramural. Intramural arteries were unroofed in 100 (88%) operations, usually with intimal tacking after incision (n = 47) or excision (n = 25) of the common wall. Coronary reimplantation (n = 11), pulmonary artery relocation (n = 7; 5 for IA/NIM), simple ostioplasty (without unroofing; n = 3), coronary artery bypass grafting (n = 2), and ostial window (n = 1) were less common. In 37 (33%) operations, a valvar commissure was taken down; 33 were resuspended. Conclusion: Current surgical repair of AAOCA is individualized to morphology, particularly the presence of intramural and/or interarterial segments. This report is foundational for future planned CHSS studies that will examine interventional and noninterventional outcomes and ultimately guide management of AAOCA.
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Affiliation(s)
- Jeffrey A. Poynter
- Congenital Heart Surgeons Society Data Center, The Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Surgery, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Igor Bondarenko
- Department of Cardiovascular Surgery, Children’s Hospital of Michigan, Detroit, MI, USA
| | - Erle H. Austin
- Kosair Children’s Hospital, University of Louisville, Louisville, KY, USA
| | - William M. DeCampli
- Department of Cardiothoracic Surgery, Arnold Palmer Hospital for Children, Orlando, FL, USA
| | - Jeffrey P. Jacobs
- Johns Hopkins All Children's Heart Institute, Johns Hopkins University, All Children's Hospital, St Petersburg, FL, USA
| | - Gerhard Ziemer
- Department of Surgery, University of Chicago, Chicago, IL, USA
| | | | | | - Tara Karamlou
- Department of Pediatric Cardiac Surgery, University of California-San Francisco Benioff Children's Hospital, San Francisco, CA, USA
| | | | - Henry L. Walters
- Department of Cardiovascular Surgery, Children’s Hospital of Michigan, Detroit, MI, USA
| | - J. William Gaynor
- Pediatric Cardiac Surgery, The Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Carlos M. Mery
- Division of Congenital Heart Surgery, Texas Children’s Hospital, Houston, TX, USA
| | - Jeffrey M. Pearl
- Glendale Department of Childhealth, University of Arizona College of Medicine, Phoenix, AZ, USA
| | - Julie A. Brothers
- Pediatric Cardiac Surgery, The Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Christopher A. Caldarone
- Division of Cardiac Surgery, University of Toronto, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - William G. Williams
- Congenital Heart Surgeons Society Data Center, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Marshall L. Jacobs
- Department of Surgery, Johns Hopkins School of Medicine, Baltimore, MD, USA
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Bernier PL, Bernier P, Fatani M, Samoukovic G, Huber T, Tchervenkov CI. Floating thrombus in the aortic arch with systemic arterial embolization. J Card Surg 2014; 29:382. [PMID: 24428190 DOI: 10.1111/jocs.12281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Pierre-Luc Bernier
- Division of Cardiac Surgery, Department of Surgery, McGill University Health Center, Montreal, Canada
| | - Pl Bernier
- Division of Cardiac Surgery, Department of Surgery, McGill University Health Center, Montreal, Canada
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Jacobs JP, Jacobs ML, Maruszewski B, Lacour-Gayet FG, Tchervenkov CI, Tobota Z, Stellin G, Kurosawa H, Murakami A, Gaynor JW, Pasquali SK, Clarke DR, Austin EH, Mavroudis C. Initial application in the EACTS and STS Congenital Heart Surgery Databases of an empirically derived methodology of complexity adjustment to evaluate surgical case mix and results. Eur J Cardiothorac Surg 2012; 42:775-9; discussion 779-80. [PMID: 22700597 PMCID: PMC3858079 DOI: 10.1093/ejcts/ezs026] [Citation(s) in RCA: 105] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2011] [Revised: 12/06/2011] [Accepted: 12/12/2011] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES Outcomes evaluation is enhanced by assignment of operative procedures to appropriate categories based upon relative average risk. Formal risk modelling is challenging when a large number of operation types exist, including relatively rare procedures. Complexity stratification provides an alternative methodology. We report the initial application in the Congenital Heart Surgery Databases of the Society of Thoracic Surgeons (STS) and the European Association for Cardio-thoracic Surgery (EACTS) of an empirically derived system of complexity adjustment to evaluate surgical case mix and results. METHODS Complexity stratification is a method of analysis in which the data are divided into relatively homogeneous groups (called strata). A complexity stratification tool named the STS-EACTS Congenital Heart Surgery Mortality Categories (STAT Mortality Categories) was previously developed based on the analysis of 77,294 operations entered in the Congenital Heart Surgery Databases of EACTS (33,360 operations) and STS (43,934 patients). Procedure-specific mortality rate estimates were calculated using a Bayesian model that adjusted for small denominators. Operations were sorted by increasing risk and grouped into five categories (the STAT Mortality Categories) that were designed to minimize within-category variation and maximize between-category variation. We report here the initial application of this methodology in the EACTS Congenital Heart Surgery Database (47,187 operations performed over 4 years: 2006-09) and the STS Congenital Heart Surgery Database (64,307 operations performed over 4 years: 2006-09). RESULTS In the STS Congenital Heart Surgery Database, operations classified as STAT Mortality Categories 1-5 were (1): 17332, (2): 20114, (3): 9494, (4): 14525 and (5): 2842. Discharge mortality was (1): 0.54%, (2): 1.6%, (3): 2.4%, (4): 7.5% and (5): 17.8%. In the EACTS Congenital Heart Surgery Database, operations classified as STAT Mortality Categories 1-5 were (1): 19874, (2): 12196, (3): 5614, (4): 8287 and (5): 1216. Discharge mortality was (1): 0.99%, (2): 2.9%, (3): 5.0%, (4): 10.3% and (5): 25.0%. CONCLUSIONS The STAT Mortality Categories facilitate analysis of outcomes across the wide spectrum of distinct congenital heart surgery operations including infrequently performed procedures.
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Affiliation(s)
- Jeffrey Phillip Jacobs
- Division of Thoracic and Cardiovascular Surgery, The Congenital Heart Institute of Florida, All Children's Hospital, Cardiac Surgical Associates of Florida , University of South Florida College of Medicine, Saint Petersburg and Tampa, FL 33701, USA.
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Hickey EJ, Caldarone CA, Blackstone EH, Williams WG, Yeh T, Pizarro C, Lofland G, Tchervenkov CI, Pigula F, McCrindle BW. Biventricular strategies for neonatal critical aortic stenosis: High mortality associated with early reintervention. J Thorac Cardiovasc Surg 2012; 144:409-17, 417.e1. [DOI: 10.1016/j.jtcvs.2011.09.076] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2010] [Revised: 08/09/2011] [Accepted: 09/15/2011] [Indexed: 10/28/2022]
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Jacobs JP, O'Brien SM, Pasquali SK, Jacobs ML, Lacour-Gayet FG, Tchervenkov CI, Austin EH, Pizarro C, Pourmoghadam KK, Scholl FG, Welke KF, Gaynor JW, Clarke DR, Mayer JE, Mavroudis C. Variation in outcomes for risk-stratified pediatric cardiac surgical operations: an analysis of the STS Congenital Heart Surgery Database. Ann Thorac Surg 2012; 94:564-71; discussion 571-2. [PMID: 22704799 DOI: 10.1016/j.athoracsur.2012.01.105] [Citation(s) in RCA: 96] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2011] [Revised: 01/15/2012] [Accepted: 01/19/2012] [Indexed: 10/28/2022]
Abstract
BACKGROUND We evaluated outcomes for groups of risk-stratified operations in The Society of Thoracic Surgeons Congenital Heart Surgery Database to provide contemporary benchmarks and examine variation between centers. METHODS Patients undergoing surgery from 2005 to 2009 were included. Centers with more than 10% missing data were excluded. Discharge mortality and postoperative length of stay (PLOS) among patients discharged alive were calculated for groups of risk-stratified operations using the five Society of Thoracic Surgeons-European Association for Cardio-Thoracic Surgery Congenital Heart Surgery mortality categories (STAT Mortality Categories). Power for analyzing between-center differences in outcome was determined for each STAT Mortality Category. Variation was evaluated using funnel plots and Bayesian hierarchical modeling. RESULTS In this analysis of risk-stratified operations, 58,506 index operations at 73 centers were included. Overall discharge mortality (interquartile range among programs with more than 10 cases) was as follows: STAT Category 1=0.55% (0% to 1.0%), STAT Category 2=1.7% (1.0% to 2.2%), STAT Category 3=2.6% (1.1% to 4.4%), STAT Category 4=8.0% (6.3% to 11.1%), and STAT Category 5=18.4% (13.9% to 27.9%). Funnel plots with 95% prediction limits revealed the number of centers characterized as outliers by STAT Mortality Categories was as follows: Category 1=3 (4.1%), Category 2=1 (1.4%), Category 3=7 (9.7%), Category 4=13 (17.8%), and Category 5=13 (18.6%). Between-center variation in PLOS was analyzed for all STAT Categories and was greatest for STAT Category 5 operations. CONCLUSIONS This analysis documents contemporary benchmarks for risk-stratified pediatric cardiac surgical operations grouped by STAT Mortality Categories and the range of outcomes among centers. Variation was greatest for the more complex operations. These data may aid in the design and planning of quality assessment and quality improvement initiatives.
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Affiliation(s)
- Jeffrey Phillip Jacobs
- The Congenital Heart Institute of Florida (CHIF), All Children's Hospital, University of South Florida College of Medicine, Saint Petersburg and Tampa, Saint Petersburg, Florida 33701, USA.
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Giroud JM, Jacobs JP, Fricker FJ, Spicer D, Backer C, Franklin RC, Beland MJ, Krogmann ON, Aiello VD, Colan SD, Everett AD, Gaynor JW, Kurosawa H, Maruszewski B, Stellin G, Tchervenkov CI, Walters HL, Weinberg P, Fogel MA, Jacobs ML, Elliott MJ, Anderson RH. Web based “Global Virtual Museum of Congenital Cardiac Pathology”. Progress in Pediatric Cardiology 2012. [DOI: 10.1016/j.ppedcard.2011.12.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Jacobs JP, Jacobs ML, Austin EH, Mavroudis C, Pasquali SK, Lacour–Gayet FG, Tchervenkov CI, Walters H, Bacha EA, del Nido PJ, Fraser CD, Gaynor JW, Hirsch JC, Morales DLS, Pourmoghadam KK, Tweddell JS, Prager RL, Mayer JE. Quality measures for congenital and pediatric cardiac surgery. World J Pediatr Congenit Heart Surg 2012; 3:32-47. [PMID: 23804682 PMCID: PMC3827684 DOI: 10.1177/2150135111426732] [Citation(s) in RCA: 79] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This article presents 21 "Quality Measures for Congenital and Pediatric Cardiac Surgery" that were developed and approved by the Society of Thoracic Surgeons (STS) and endorsed by the Congenital Heart Surgeons' Society (CHSS). These Quality Measures are organized according to Donabedian's Triad of Structure, Process, and Outcome. It is hoped that these quality measures can aid in congenital and pediatric cardiac surgical quality assessment and quality improvement initiatives.
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Affiliation(s)
- Jeffrey Phillip Jacobs
- Division of Thoracic and Cardiovascular Surgery, The Congenital Heart Institute of Florida (CHIF), All Children’s Hospital, Cardiac Surgical Associates of Florida (CSAoF), University of South Florida College of Medicine, St Petersburg and Tampa, FL, USA
| | - Marshall Lewis Jacobs
- Center for Pediatric and Congenital Heart Diseases, Children’s Hospital, Cleveland Clinic, Cleveland, OH, USA
| | - Erle H. Austin
- Kosair Children’s Hospital, University of Louisville, Louisville, KY, USA
| | - Constantine Mavroudis
- Department of Pediatric and Congenital Heart Surgery, Cleveland Clinic, Cleveland Clinic Lerner School of Medicine, Cleveland, OH, USA
| | - Sara K. Pasquali
- Department of Pediatrics, Duke University School of Medicine, and Duke Clinical Research Institute, Durham, NC, USA
| | | | - Christo I. Tchervenkov
- Division of Pediatric Cardiovascular Surgery, The Montreal Children’s Hospital of the McGill University Health Centre, Montréal, Quebec, Canada
| | - Hal Walters
- Children’s Hospital of Michigan, Wayne State University School of Medicine, Detroit, MI, USA
| | - Emile A. Bacha
- Morgan Stanley Children’s Hospital of New York (CHONY)/Columbia University, New York, NY, USA
| | - Pedro J. del Nido
- Children’s Hospital Boston, Harvard University Medical School, Boston, MA, USA
| | - Charles D. Fraser
- Division of Congenital Heart Surgery, Texas Children’s Hospital, Baylor College of Medicine, Houston, TX, USA
| | - J. William Gaynor
- Cardiac Surgery, Children’s Hospital of Philadelphia, Philadelphia, PA, USA
| | - Jennifer C. Hirsch
- Department of Cardiac Surgery, University of Michigan Medical School, Ann Arbor, MI, USA
| | - David L. S. Morales
- Division of Congenital Heart Surgery, Texas Children’s Hospital, Baylor College of Medicine, Houston, TX, USA
| | | | - James S. Tweddell
- Department of Cardiothoracic Surgery, Children’s Hospital of Wisconsin, Milwaukee, WI, USA
| | - Richard L. Prager
- Department of Cardiac Surgery, University of Michigan Medical School, Ann Arbor, MI, USA
| | - John E. Mayer
- Children’s Hospital Boston, Harvard University Medical School, Boston, MA, USA
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Jacobs JP, Pasquali SK, Morales DLS, Jacobs ML, Mavroudis C, Chai PJ, Tchervenkov CI, Lacour-Gayet FG, Walters H, Quintessenza JA. Heterotaxy: lessons learned about patterns of practice and outcomes from the congenital heart surgery database of the society of thoracic surgeons. World J Pediatr Congenit Heart Surg 2011; 2:278-86. [PMID: 23804985 PMCID: PMC3695419 DOI: 10.1177/2150135110397670] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
According to The International Society for Nomenclature of Pediatric and Congenital Heart Disease (ISNPCHD), "Heterotaxy is synonymous with 'visceral heterotaxy' and 'heterotaxy syndrome'. Heterotaxy is defined as an abnormality where the internal thoraco-abdominal organs demonstrate abnormal arrangement across the left-right axis of the body. By convention, heterotaxy does not include patients with either the expected usual or normal arrangement of the internal organs along the left-right axis, also known as 'situs solitus', or patients with complete mirror-imaged arrangement of the internal organs along the left-right axis also known as `situs inversus'." or patients with complete mirror-image arrangement of the internal organs along the left-right axis, also known as situs inversus. The purpose of this article is to review the data about heterotaxy in the Society of Thoracic Surgeons (STS) Congenital Heart Surgery Database. The investigators examined all index operations in the STS Congenital Heart Surgery Database over 12 years from January 1, 1998 to December 31, 2009, inclusive. This analysis resulted in a cohort of 77 153 total index operations. Of these, 1505 operations (1.95%) were performed in patients with heterotaxy. Of the 1505 index operations performed in patients with heterotaxy, 1144 were in patients with asplenia and 361 were in patients with polysplenia. In every STS -EACTS Congenital Heart Surgery Mortality Category, discharge mortality is higher in patients with heterotaxy compared with patients without heterotaxy (EACTS = European Association for Cardio-Thoracic Surgery). Discharge mortality after systemic to pulmonary artery shunt is 6.6% in a cohort of all single-ventricle patients except those with heterotaxy, whereas it is 10.8% in single-ventricle patients with heterotaxy. Discharge mortality after Fontan is 1.8% in a cohort of all single-ventricle patients except those with heterotaxy, whereas it is 4.2% in single-ventricle patients with heterotaxy. The STS Congenital Heart Surgery Database is largest congenital heart surgery database in North America. This review of data from the STS Congenital Heart Surgery Database allows for unique documentation of practice patterns and outcomes. From this analysis, it is clear that heterotaxy is a challenging problem with increased discharge mortality in most subgroups.
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Affiliation(s)
- Jeffrey Phillip Jacobs
- The Congenital Heart Institute of Florida (CHIF), All Children's Hospital and Children's Hospital of Tampa, University of South Florida College of Medicine, Cardiac Surgical Associates of Florida (CSAoF), Saint Petersburg and Tampa, FL, USA
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Jacobs JP, Jacobs ML, Mavroudis C, Chai PJ, Tchervenkov CI, Lacour-Gayet FG, Walters H, Quintessenza JA. Transposition of the Great Arteries. World J Pediatr Congenit Heart Surg 2010; 2:19-31. [DOI: 10.1177/2150135110381392] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The Society of Thoracic Surgeons (STS) Congenital Heart Surgery Database contains data about 3258 patients with the diagnosis of transposition of the great arteries (TGA) who underwent surgery during the 4-year time interval from July 1, 2005 to June 30, 2009, inclusive. This cohort includes 2918 patients with concordant atrioventricular connections and discordant ventriculoarterial connections and 341 patients with congenitally corrected TGA (discordant atrioventricular connections and discordant ventriculoarterial connections). The 4 most common operations were the following: (1) arterial switch operation (ASO) for TGA with intact ventricular septum (n = 1196), (2) ASO with ventricular septal defect (VSD) repair for TGA with VSD (n = 420), (3) ASO with VSD repair and aortic arch repair for TGA with VSD and hypoplastic arch (n = 55), and (4) Rastelli operation for TGA with VSD and left ventricular outflow tract obstruction (n = 49). Detailed preoperative, intraoperative, and postoperative data were obtained about patients who underwent these 4 operations. Median age at surgery (days) was as follows: ASO: 6.0; ASO with VSD repair: 7.0; ASO with VSD repair and aortic arch repair: 7.0; and Rastelli: 309.0. Mean age at surgery (days) was as follows: ASO: 22.9; ASO with VSD repair: 24.8; ASO with VSD repair and aortic arch repair: 14.4; and Rastelli: 721.8. Discharge mortality was as follows: ASO: 2.2%; ASO with VSD repair: 5.5%; ASO with VSD repair and aortic arch repair: 7.3%; and Rastelli: 0%. Median length of stay (days) was as follows: ASO: 11.0; ASO with VSD repair: 11.0; ASO with VSD repair and aortic arch repair: 18.0; and Rastelli: 7.0. The sternum was left open in the following: ASO: 24.8%; ASO with VSD repair: 29.5%; ASO with VSD repair and aortic arch repair: 40.0%; and Rastelli: 6.1%. This review of data from the STS Congenital Heart Surgery Database allows for unique documentation of patterns of practice and outcomes. From this review, we learned that although surgery for TGA is often complex and may be associated with morbidity, most patients survive without major complications.
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Affiliation(s)
- Jeffrey Phillip Jacobs
- The Congenital Heart Institute of Florida (CHIF), All Children’s Hospital and Children’s Hospital of Tampa, University of South Florida College of Medicine, Cardiac Surgical Associates of Florida (CSAoF), St Petersburg and Tampa, Florida, USA
| | - Marshall Lewis Jacobs
- Cleveland Clinic Foundation, Cleveland Clinic Lerner School of Medicine, Case Western Reserve University, Cleveland, Ohio, USA
| | - Constantine Mavroudis
- Cleveland Clinic Foundation, Cleveland Clinic Lerner School of Medicine, Case Western Reserve University, Cleveland, Ohio, USA
| | - Paul Jubeong Chai
- The Congenital Heart Institute of Florida (CHIF), All Children’s Hospital and Children’s Hospital of Tampa, University of South Florida College of Medicine, Cardiac Surgical Associates of Florida (CSAoF), St Petersburg and Tampa, Florida, USA
| | - Christo I. Tchervenkov
- The Montreal Children’s Hospital of the McGill University Health Centre, Montreal, Quebec, Canada
| | | | - Henry Walters
- Children’s Hospital of Michigan, Wayne State University School of Medicine, Detroit, Michigan, USA
| | - James Anthony Quintessenza
- The Congenital Heart Institute of Florida (CHIF), All Children’s Hospital and Children’s Hospital of Tampa, University of South Florida College of Medicine, Cardiac Surgical Associates of Florida (CSAoF), St Petersburg and Tampa, Florida, USA
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Sandoval N, Kreutzer C, Jatene M, Sessa TD, Novick W, Jacobs JP, Bernier PL, Tchervenkov CI. Pediatric Cardiovascular Surgery in South America. World J Pediatr Congenit Heart Surg 2010; 1:321-7. [DOI: 10.1177/2150135110381391] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Very little information is available about the epidemiology of congenital heart disease in developing parts of the world, including South America. This article describes the incidence of congenital cardiac disease, the different treatment rates among countries, and future solutions for achieving improved coverage for the children with cardiac diseases in South America. An incidence of congenital cardiac disease of 8 per 1000 live births appears to be a fair approximation for the population of the world and also the population in South America. Nevertheless, a wide variation exists in the observed incidence of congenital cardiac disease in South American countries, which can be partly explained by inequalities in the access to diagnosis, differences in the diagnostic criteria, and true regional variations. It is estimated that 58,718 children are born yearly with congenital heart disease in South America. Brazil, Colombia, and Argentina have the highest number, followed by Peru, Venezuela, Chile, Ecuador, Bolivia, Paraguay, Uruguay, and Guyana. It is also estimated that in South America, 24,081 children per year with a new diagnosis of congenital cardiac disease do not receive any treatment. This paper provides strategies for improving the access to and quality of pediatric cardiac surgery in South America.
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Affiliation(s)
- Nestor Sandoval
- Fundación Cardioinfantil, Instituto de Cardiología, Bogotá, Colombia
| | - Christian Kreutzer
- Hospital Nacional Alejandro Posadas, Hospital Universitario Austral, Buenos Aires, Argentina
| | | | | | - William Novick
- International Children Heart Foundation, University of Tennessee, Memphis, Tennessee, USA
| | - Jeffrey Phillip Jacobs
- The Congenital Heart Institute of Florida (CHIF), All Children’s Hospital, Children’s Hospital of Tampa, University of South Florida College of Medicine, Cardiac Surgical Associates of Florida (CSAoF), St Petersburg and Tampa, Florida, USA
| | - Pierre-Luc Bernier
- Division of Pediatric Cardiovascular Surgery, The Montreal Children’s Hospital of the McGill University Health Centre, Montréal, Quebec, Canada
| | - Christo I Tchervenkov
- Division of Pediatric Cardiovascular Surgery, The Montreal Children’s Hospital of the McGill University Health Centre, Montréal, Quebec, Canada
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Giroud JM, Jacobs JP, Spicer D, Backer C, Martin GR, Franklin RCG, Béland MJ, Krogmann ON, Aiello VD, Colan SD, Everett AD, William Gaynor J, Kurosawa H, Maruszewski B, Stellin G, Tchervenkov CI, Walters HL, Weinberg P, Anderson RH, Elliott MJ. Report From The International Society for Nomenclature of Paediatric and Congenital Heart Disease. World J Pediatr Congenit Heart Surg 2010; 1:300-13. [PMID: 23804886 DOI: 10.1177/2150135110379622] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Tremendous progress has been made in the field of pediatric heart disease over the past 30 years. Although survival after heart surgery in children has improved dramatically, complications still occur, and optimization of outcomes for all patients remains a challenge. To improve outcomes, collaborative efforts are required and ultimately depend on the possibility of using a common language when discussing pediatric and congenital heart disease. Such a universal language has been developed and named the International Pediatric and Congenital Cardiac Code (IPCCC). To make the IPCCC more universally understood, efforts are under way to link the IPCCC to pictures and videos. The Archiving Working Group is an organization composed of leaders within the international pediatric cardiac medical community and part of the International Society for Nomenclature of Paediatric and Congenital Heart Disease ( www.ipccc.net ). Its purpose is to illustrate, with representative images of all types and formats, the pertinent aspects of cardiac diseases that affect neonates, infants, children, and adults with congenital heart disease, using the codes and definitions associated with the IPCCC as the organizational backbone. The Archiving Working Group certifies and links images and videos to the appropriate term and definition in the IPCCC. These images and videos are then displayed in an electronic format on the Internet. The purpose of this publication is to report the recent progress made by the Archiving Working Group in establishing an Internet-based, image encyclopedia that is based on the standards of the IPCCC.
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Affiliation(s)
- Jorge M. Giroud
- The Congenital Heart Institute of Florida (CHIF), Division of Pediatric Cardiology, All Children’s Hospital and Children’s Hospital of Tampa, University of South Florida College of Medicine, Pediatric Cardiology Associates/Pediatrix Medical Group, Saint Petersburg and Tampa, FL, USA
| | - Jeffrey P. Jacobs
- The Congenital Heart Institute of Florida (CHIF), Division of Thoracic and Cardiovascular Surgery, All Children’s Hospital and Children’s Hospital of Tampa, University of South Florida College of Medicine, Cardiac Surgical Associates of Florida (CSSofF), Saint Petersburg and Tampa, FL, USA
| | - Diane Spicer
- The Congenital Heart Institute of Florida (CHIF), Division of Pediatric Cardiology, All Children’s Hospital and Children’s Hospital of Tampa, University of South Florida College of Medicine, Pediatric Cardiology Associates/Pediatrix Medical Group, Saint Petersburg and Tampa, FL, USA
- The Congenital Heart Institute of Florida (CHIF), Division of Thoracic and Cardiovascular Surgery, All Children’s Hospital and Children’s Hospital of Tampa, University of South Florida College of Medicine, Cardiac Surgical Associates of Florida (CSSofF), Saint Petersburg and Tampa, FL, USA
| | - Carl Backer
- Children’s Memorial Hospital, Chicago, IL, USA
| | - Gerard R. Martin
- Center for Heart, Lung and Kidney Disease, Children’s National Medical Center, Washington, DC, USA
| | | | - Marie J. Béland
- Division of Pediatric Cardiology, The Montreal Children’s Hospital of the McGill University Health Centre, Montréal, Quebec, Canada
| | - Otto N. Krogmann
- Paediatric Cardiology–CHD, Heart Center Duisburg, Duisburg, Germany
| | - Vera D. Aiello
- Heart Institute (InCor), Sao Paulo University, School of Medicine, Sao Paulo, Brazil
| | - Steven D. Colan
- Department of Cardiology, Children’s Hospital, Boston, MA, USA
| | - Allen D. Everett
- Pediatric Cardiology, Johns Hopkins University, Baltimore, MD, USA
| | - J. William Gaynor
- Cardiac Surgery, Children’s Hospital of Philadelphia, Philadelphia, PA, USA
| | - Hiromi Kurosawa
- Cardiovascular Surgery, Heart Institute of Japan, Tokyo Women’s Medical University, Tokyo, Japan
| | - Bohdan Maruszewski
- The Children’s Memorial Health Institute, Department of Cardiothoracic Surgery, Warsaw, Poland
| | - Giovanni Stellin
- Pediatric Cardiac Surgery Unit, University of Padova Medical School, Padova, Italy
| | - Christo I. Tchervenkov
- Division of Pediatric Cardiovascular Surgery, The Montreal Children’s Hospital of the McGill University Health Centre, Montréal, Quebec, Canada
| | - Henry L. Walters
- Children’s Hospital of Michigan, Wayne State University School of Medicine, Detroit, MI, USA
| | - Paul Weinberg
- Division of Pediatric Cardiology, The Children’s Hospital of Philadelphia, PA, USA
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Al Habib HF, Jacobs JP, Mavroudis C, Tchervenkov CI, O'Brien SM, Mohammadi S, Jacobs ML. Contemporary Patterns of Management of Tetralogy of Fallot: Data From The Society of Thoracic Surgeons Database. Ann Thorac Surg 2010; 90:813-9; discussion 819-20. [DOI: 10.1016/j.athoracsur.2010.03.110] [Citation(s) in RCA: 193] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2010] [Revised: 03/16/2010] [Accepted: 03/19/2010] [Indexed: 11/16/2022]
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Jacobs JP, Maruszewski B, Kurosawa H, Jacobs ML, Mavroudis C, Lacour-Gayet FG, Tchervenkov CI, Walters H, Stellin G, Ebels T, Tsang VT, Elliott MJ, Murakami A, Sano S, Mayer JE, Edwards FH, Quintessenza JA. Congenital heart surgery databases around the world: do we need a global database? Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu 2010; 13:3-19. [PMID: 20307856 DOI: 10.1053/j.pcsu.2010.02.003] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The question posed in the title of this article is: "Congenital Heart Surgery Databases Around the World: Do We Need a Global Database?" The answer to this question is "Yes and No"! Yes--we need to create a global database to track the outcomes of patients with pediatric and congenital heart disease. No--we do not need to create a new "global database." Instead, we need to create a platform that allows for the linkage of currently existing continental subspecialty databases (and continental subspecialty databases that might be created in the future) that will allow for the seamless sharing of multi-institutional longitudinal data across temporal, geographical, and subspecialty boundaries. This review article will achieve the following objectives: (A) Consider the current state of analysis of outcomes of treatments for patients with congenitally malformed hearts. (B) Present some principles that might make it possible to achieve life-long longitudinal monitoring and follow-up. (C) Describe the rationale for the creation of a Global Federated Multispecialty Congenital Heart Disease Database. (D) Propose a methodology for the creation of a Global Federated Multispecialty Congenital Heart Disease Database that is based on linking together currently existing databases without creating a new database. To perform meaningful multi-institutional analyses, any database must incorporate the following six essential elements: (1) Use of a common language and nomenclature. (2) Use of a database with an established uniform core dataset for collection of information. (3) Incorporation of a mechanism to evaluate the complexity of cases. (4) Implementation of a mechanism to assure and verify the completeness and accuracy of the data collected. (5) Collaboration between medical and surgical subspecialties. (6) Standardization of protocols for life-long longitudinal follow-up. Analysis of outcomes must move beyond recording 30-day or hospital mortality, and encompass longer-term follow-up, including cardiac and non-cardiac morbidities, and importantly, those morbidities impacting health-related quality of life. Methodologies must be implemented in our databases to allow uniform, protocol-driven, and meaningful long-term follow-up. We need to create a platform that allows for the linkage of currently existing continental subspecialty databases (and continental subspecialty databases that might be created in the future) that will allow for the seamless sharing of multi-institutional longitudinal data across temporal, geographical, and subspecialty boundaries. This "Global Federated Multispecialty Congenital Heart Disease Database" will not be a new database, but will be a platform that effortlessly links multiple databases and maintains the integrity of these extant databases. Description of outcomes requires true multi-disciplinary involvement, and should include surgeons, cardiologists, anesthesiologists, intensivists, perfusionists, neurologists, educators, primary care physicians, nurses, and physical therapists. Outcomes should determine primary therapy, and as such must be monitored life-long. The relatively small numbers of patients with congenitally malformed hearts requires multi-institutional cooperation to accomplish these goals. The creation of a Global Federated Multispecialty Congenital Heart Disease Database that links extant databases from pediatric cardiology, pediatric cardiac surgery, pediatric cardiac anesthesia, and pediatric critical care will create a platform for improving patient care, research, and teaching related to patients with congenital and pediatric cardiac disease.
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Affiliation(s)
- Jeffrey Phillip Jacobs
- The Congenital Heart Institute of Florida, All Children's Hospital and Children's Hospital of Tampa, and Department of Surgery, University of South Florida College of Medicine, 625 Sixth Ave. South, St Petersburg, FL 33701, USA.
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Jacobs JP, Jacobs ML, Mavroudis C, Chai PJ, Tchervenkov CI, Lacour-Gayet FG, Walters H, Quintessenza JA. Atrioventricular Septal Defects: Lessons Learned About Patterns of Practice and Outcomes From the Congenital Heart Surgery Database of the Society of Thoracic Surgeons. World J Pediatr Congenit Heart Surg 2010; 1:68-77. [DOI: 10.1177/2150135110361504] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
During the 4-year time interval of 2005 through 2008, the Society of Thoracic Surgeons Congenital Heart Surgery Database documented data about 2882 operations to repair atrioventricular (AV) canal defects: partial, 623 (21.5%); intermediate, 342 (11.8%);. complete, 1917 (66.3%). Mean age at complete repair (years) was as follows: partial, 6.1; intermediate, 2.9; complete, 0.6. Median age at complete repair (years) was as follows: partial, 2.6; intermediate, 0.9; complete, 0.4. Down syndrome was present in 1767 patients (61.1%). Debanding of the pulmonary artery was rarely performed: partial, 1 (0.2%); intermediate, 0 (0.0%); complete, 66 (3.4%). Deep hypothermic circulatory arrest was rarely used: partial, 6 (1.0%); intermediate, 5 (1.5%); complete, 52 (2.7%). Discharge mortality was low: partial, 2 (0.3%); intermediate, 3 (0.9%); complete, 38 (2.0%). Atrioventricular block requiring permanent pacemaker occurred but was uncommon: partial, 6 (1.0%); intermediate, 2 (0.6%); complete, 29 (1.5%). Unplanned reoperation prior to hospital discharge occurred in 3.9% of complete AV canal repairs. The sternum was left open in 3.0% of complete AV canal repairs. Postoperative cardiac arrest occurred in 1.9% of complete AV canal repairs. Mean postoperative length of stay (days) was as follows: partial, 5.2; intermediate, 7; complete, 13.1. Median postoperative length of stay (days) was as follows: partial, 4; intermediate, 4; complete, 7. This review of data from the Society of Thoracic Surgeons Congenital Heart Surgery Database allows for unique documentation of patterns of practice and outcomes. From this review, we learned that 98% to 99% of patients survive complete repair of AV canal and 96% to 97% survive complete repair of AV canal with no major complications.
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Affiliation(s)
- Jeffrey Phillip Jacobs
- Congenital Heart Institute of Florida, All Children’s Hospital and Children’s Hospital of Tampa, University of South Florida College of Medicine, Cardiac Surgical Associates of Florida, Saint Petersburg and Tampa, FL, USA
| | - Marshall Lewis Jacobs
- Cleveland Clinic Foundation, Cleveland Clinic Lerner School of Medicine, Case Western Reserve University, Cleveland, OH, USA
| | - Constantine Mavroudis
- Cleveland Clinic Foundation, Cleveland Clinic Lerner School of Medicine, Case Western Reserve University, Cleveland, OH, USA
| | - Paul Jubeong Chai
- Congenital Heart Institute of Florida, All Children’s Hospital and Children’s Hospital of Tampa, University of South Florida College of Medicine, Cardiac Surgical Associates of Florida, Saint Petersburg and Tampa, FL, USA
| | - Christo I. Tchervenkov
- Montreal Children’s Hospital of the McGill University Health Centre, Montreal, Quebec, Canada
| | | | - Hal Walters
- Children’s Hospital of Michigan, Wayne State University School of Medicine, Detroit, MI, USA
| | - James Anthony Quintessenza
- Congenital Heart Institute of Florida, All Children’s Hospital and Children’s Hospital of Tampa, University of South Florida College of Medicine, Cardiac Surgical Associates of Florida, Saint Petersburg and Tampa, FL, USA
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Tchervenkov CI, Bernier PL, Duca DD, Hill S, Ota N, Samoukovic G, Al-Habib H, Korkola S. Repair of atrioventricular canal with double-outlet right ventricle, transposition, or truncus arteriosus. World J Pediatr Congenit Heart Surg 2010; 1:119-26. [PMID: 23804732 DOI: 10.1177/2150135110362093] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Atrioventricular canal and conotruncal anomalies are a heterogeneous group of lesions presenting unique challenges for surgical repair. These are the establishment of unobstructed pathways from left ventricle (LV) to aorta and from right ventricle (RV) to pulmonary artery, closure of the inlet ventricular septal defect (VSD) and atrial septal defect (ASD) ostium primum, and the avoidance of significant left and right atrioventricular valve (AV) regurgitation. Repair of complete atrioventricular canal (CAVC) with tetralogy of Fallot (TOF) has been most commonly achieved, either using a single-patch or a 2-patch technique. In patients with CAVC with double-outlet right ventricle (DORV) with subaortic VSD extension, the 2-patch repair is not unlike that of CAVC with TOF. However, biventricular repair is most challenging in patients with CAVC and complete origin of the aorta from the RV, as in CAVC with DORV and noncommitted VSD and those with CAVC with transposition of the great arteries (TGA) and LVOTO. The technique of VSD translocation allows anatomic biventricular repair for these particularly challenging patients. The arterial switch operation with CAVC repair can be used for patients with CAVC with DORV with subpulmonary VSD extension and CAVC with TGA without left ventricular outflow tract obstruction. Biventricular repair is achievable in most patients with balanced complete atrioventricular canal and conotruncal anomaly. The extreme heterogeneity of CAVC with conotruncal anomalies requires a highly individual approach that is tailored to the specific constellation of lesions in each patient.
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Affiliation(s)
- Christo I Tchervenkov
- Montreal Children's Hospital of the McGill University Health Center, Montreal, Québec, Canada
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Jacobs JP, Jacobs ML, Mavroudis C, Maruszewski B, Lacour-Gayet FG, Tchervenkov CI. A Correction to an Analysis From the EACTS and STS Congenital Heart Surgery Databases. Ann Thorac Surg 2010; 89:1339. [DOI: 10.1016/j.athoracsur.2009.11.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2009] [Revised: 10/04/2009] [Accepted: 11/02/2009] [Indexed: 11/27/2022]
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Bernier PL, Stefanescu A, Samoukovic G, Tchervenkov CI. The challenge of congenital heart disease worldwide: epidemiologic and demographic facts. Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu 2010; 13:26-34. [PMID: 20307858 DOI: 10.1053/j.pcsu.2010.02.005] [Citation(s) in RCA: 254] [Impact Index Per Article: 18.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
Congenital heart disease (CHD) afflicts a large number of children every year. The incidence of CHD is generally considered to be 8 per 1,000 live births. However, this estimate is perhaps inaccurate and does not take into consideration regional differences. A large review of the literature was performed to establish the true incidence of CHD and geographical variations. Data on the incidence of specific lesions and their geographical variation, as well as on mortality from CHD, was also reviewed. Taking into consideration the available data on incidence, mortality, and access to care, the global challenge that CHD represents was analyzed. Insight into how to confront this challenge is given.
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Affiliation(s)
- Pierre-Luc Bernier
- Division of Cardiovascular Surgery, The Montreal Children's Hospital of the McGill University Health Centre, Montreal, Quebec, Canada
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Dearani JA, Neirotti R, Kohnke EJ, Sinha KK, Cabalka AK, Barnes RD, Jacobs JP, Stellin G, Tchervenkov CI, Cushing JC. Improving pediatric cardiac surgical care in developing countries: matching resources to needs. Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu 2010; 13:35-43. [PMID: 20307859 DOI: 10.1053/j.pcsu.2010.02.001] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
This article reviews a systematic approach to the design and support of pediatric cardiac surgery programs in the developing world with the guidance and strategies of Children's HeartLink, an experienced non-government organization for more than 40 years. An algorithm with criteria for the selection of a partner site is outlined. A comprehensive education strategy from the physician to the allied health care provider is the mainstay for successful program development. In a partner program, the road to successful advancement and change depends on many factors, such as government support, hospital administration support, medical staff leadership, and a committed and motivated faculty with requisite skills, incentives, and resources. In addition to these factors, it is essential that the development effort includes considerations of environment (eg, governmental support, regulatory environment, and social structure) and health system (elements related to affordability, access, and awareness of care) that impact success. Partner programs should be willing to initiate a clinical database with the intent to analyze and critique their results to optimize quality assurance and improve outcomes.
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