First Harvest of Pediatric and Congenital Heart Surgery Multicenter Database in Turkey: Novel Application of Real-Time Online Reporting

Abstract

Objectives:

A new congenital heart surgery database (CKCV) with real-time online reporting function was recently developed in Turkey. All standard international parameters were used, but Aristotle Comprehensive Complexity score was modified. In this study, the first analysis of the CKCV Database is reported.

Methods:

The CKCV Database included 2307 procedures from 12 centers between January 2018 and March 2020. All parameters, including 10 real-time online reports, which represent the number of centers, number and mortality rates of all procedures, number of extracorporeal membrane oxygenation (ECMO) and results, details of postoperative complications, age-group statistics, analysis for priority status, mean intensive care and hospital stay durations of the procedures, results of Aristotle Basic, Modified Aristotle Comprehensive (MACC) and Society of Thoracic Surgeons-European Association (STAT) Score Categories, comparison of centers were analyzed.

Results:

Most common 10 procedures were ventricular septal defect (VSD) repair (n = 273), tetralogy of Fallot (TOF) repair (n = 243), atrial septal defect (ASD) repair (n = 181), complete AVSD repair (n = 95), cavopulmonary anastomosis (n = 81), systemic to pulmonary shunt (n = 79), modified Fontan (n = 71), subaortic resection, (n = 66) PA banding (n = 66), and arterial switch operation (n = 66). Cardiopulmonary bypass was used in 84.6% of the procedures. Overall mortality rate was 6.0%. A total of 618 major and 570 minor complications were observed in 333 and 412 patients, respectively. According to six MACC categories, number of the patients and mortality rates were I (293; 0.3%); II (713; 1.4%); III (601; 3.3%); IV (607; 12%); V (84; 35.7%); and VI (9; 55.6%), respectively. Analysis of five STAT Categories showed 0.7, 3.8, 5.4, 14.9, and 54.7% mortality rates.

Conclusions:

CKCV Database has a great potential for nationwide quality improvement studies. Users could instantly analyze and compare their results to national and international aggregate data using a real-time online reporting function. This is the first multicenter congenital database study in Turkey.

Keywords

database cardiac surgical procedures registries congenital heart defects

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References

Aytac

Tekdoğan

Erbil

. First 100 congenital heart operation in Hacettepe University Hospital. Cocuk sağlığı ve Hastalıkları Dergisi. 1963;6:1.

Jenkins

. Risk adjustment for congenital heart surgery: the RACHS-1 method. Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu. 2004;7:180–184.

Lacour-Gayet

Jacobs

DCJ

Comas

, et al. The Aristotle Committee. The Aristotle score: a complexity-adjusted method to evaluate surgical results. Eur J Cardiothorac Surg. 2004;25(6):911–924.

O'Brien

Clarke

Jacobs

, et al. An empirically based tool for analyzing mortality associated with congenital heart surgery. J Thorac Cardiovasc Surg. 2009;138(5):1139–1153.

Sarıoglu

Erek

Yalcinbas

. Why national database are necessary for pediatric and congenital heart surgery practice? Turk Gogus Kalp Dama. 2019; 27(3):418–422.

Pediatric Heart Surgery Database www.ckcv.org : Accessed 27-October-2020

Franklin

RCG

Béland

Colan

, et al. Nomenclature for congenital and paediatric cardiac disease: the International Paediatric and Congenital Cardiac Code (IPCCC) and the eleventh iteration of the International Classification of Diseases (ICD-11). Cardiol Young. 2017;27(10):1872–1938.

Kotani

Tweddell

Gruber

, et al. Current cardioplegia practice in pediatric cardiac surgery: a north American multi-institutional survey. Ann Thorac Surg. 2013;96(3):923–929.

Padalino

Pittarello

Vida

Stellin

. Minimally invasive approach in surgery for congenital heart disease. 2020. http://dx.doi.org/10.5772/intechopen.87136

10.

Erek

Aydin

Temur

, et al. Outcomes of hybrid and Norwood stage I procedures for the treatment of hypoplastic left heart syndrome and its variants. Turk Gogus Kalp Dama Cerrahisi Derg . 2020;28(2):282–293.

11.

Kansy

Tobota

Maruszewsky

. Analysis of 14843 neonatal congenital heart surgical procedures in the European Association for cardiothoracic surgery congenital database. Ann Thorac Surg. 2010;89(4):1255–1259.

12.

Hasegawa

Masuda

Okumura

, et al. Trends and outcomes in neonatal cardiac surgery for congenital heart disease in Japan from 1996 to 2010. Eur J Cardiothorac Surg. 2017;51(2):301–307.

13.

Sakornpant

Kojaranjit

. First National Congenital Cardiac Surgical Database Report. The Society of Thoracic Surgeons of Thailand; 2014.

14.

Masuda

Okumura

Doki

, et al. Thoracic and cardiovascular surgery in Japan during 2014: annual report by the Japanese association for thoracic surgery. Committee for scientific Affairs, The Japanese association for thoracic surgery. Gen Thorac Cardiovasc Surg. 2016;64(11):665–697.

15.

Crowe

Brown

Pagel

, et al. Development of a diagnosis- and procedure-based risk model for 30-day outcome after pediatric cardiac surgery. J Thorac Cardiovasc Surg. 2013;145(5):1270–1278.

16.

Jacobs

O’Brien

Pasquali

, et al. The Society of thoracic surgeons congenital heart surgery database mortality risk model: Part 2—Clinical application. Ann Thorac Surg. 2015;100(3):1063–1070.

17.

Kempny

Dimopoulos

Uebing

, et al. Outcome of cardiac surgery in patients with congenital heart disease in England between 1997 and 2015. J. Wort PLoS One. 2017;12(6):e0178963.

18.

Agarwal

Wolfram

Saville

Donahue

Bichell

. Postoperative complications and association with outcomes in pediatric cardiac surgery. J Thorac Cardiovasc Surg. 2014;148(2):609–616.

19.

Jacobs

Mavroudis

Quintessenza

, et al. Reoperations for pediatric and congenital heart disease: an analysis of the Society of Thoracic Surgeons (STS) Congenital heart surgery database. Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu. 2014;17(1):2–8.

20.

Thiagarajan

Barbaro

Rycus

, et al. Extracorporeal life support organization registry international report 2016. ASAIO J. 2017;63(1):60–67.

21.

Trivedi

Glass

Clark

, et al. Clinical outcomes of neonatal and pediatric extracorporeal life support: a seventeen-year, single institution experience. Artif Organs. 2019;43(11):1085–1091.

22.

Erek

Yılmaz

Kaya

, et al. Analysis of results according to the Aristotle scoring system in congenital heart surgery. Turk Gogus Kalp Dama. 2014;22(3):509–516.

23.

Yıldız

Kasar

Ozturk

, et al. Analysis of congenital heart surgery results: a comparison of four risk scoring systems. Turk Gogus Kalp Dama. 2018;26(2):200–206.

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