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

Erek, Ersin; Yalçınbaş, Yusuf Kenan; Sariosmanoğlu, Nejat; Özkan, Murat; Yıldız, Okan; Şenkaya, İşık; Özdemir, Fatih; Biçer, Mehmet; Sarıtaş, Ayhan; Atay, Yüksel; Seçici, Serkan; Kutsal, Ali; Haydın, Sertaç; Bilen, Cagatay; Onan, Ismihan Selen; Tuncer, Osman Nuri; Çitoğlu, Görkem; Doğan, Abdullah; Türköz, Rıza; Temur, Bahar; Koç, Murat; Sarıoğlu, Cafer

doi:10.1177/2150135121995474

Cited by 5 publications

(5 citation statements)

References 22 publications

(33 reference statements)

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“…[ 8 ] As we understand from our early experience and the reports from other institutes, the mortality and morbidity rates of clinics can be quite high, when they are in the learning curve for Norwood surgery[ 9 , 10 ] and it can be speculated that Norwood surgery is still in the development phase in our country. [ 11 - 13 ] However, early mortality after Norwood surgery still stands out as the most important problem that needs to be tackled.…”

Section: Discussionmentioning

confidence: 99%

Outcomes of Norwood procedure with hypoplastic left heart syndrome: Our 12-year single-center experience

Özdemir¹,

Korun²,

Dedemoğlu³

et al. 2022

Turk Gogus Kalp Dama

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Background: In this study, we aimed to analyze the predictors and risk factors of mortality in patients who underwent Norwood I procedure with the diagnosis of hypoplastic left heart syndrome. Methods: Between January 2009 and December 2020, a total of 139 patients (95 males, 44 females) who underwent Norwood I procedure with the diagnosis of hypoplastic left heart syndrome in our center were retrospectively analyzed. Results: The median birth weight was 3,200 (range, 3,000 to 3,350) g and the median age at the time of operation was seven (range, 5 to 10) days. Pulmonary flow was achieved with a Sano shunt in the majority (72%) of patients. Survival rate was 41% after the first stage. Reoperation for bleeding (p=0.017), reoperation for residual lesion (p=0.011), and postoperative peak lactate level (p=0.029), were associated with in-hospital mortality. Nineteen (33%) of 57 patients died before the second stage. Thirty-three (58%) patients underwent second stage, and survival after the second stage was 94%. Thirteen patients underwent third stage, and survival after the third stage was 85%. Estimated probability of survival at six months, and one, two, three, and four years were 33%, 33%, 25%, 25%, and 22% respectively. Conclusion: Hospital and inter-stage mortality rates are still high and this seems to be the most challenging period in term of survival efforts of the patients with hypoplastic left heart syndrome. Early recognition and reintervention of anatomical residual defects, close follow-up in the inter-stage period, and the accumulation of multidisciplinary experience may help to improve the results to acceptable limits.

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Section: Discussionmentioning

confidence: 99%

Outcomes of Norwood procedure with hypoplastic left heart syndrome: Our 12-year single-center experience

Özdemir¹,

Korun²,

Dedemoğlu³

et al. 2022

Turk Gogus Kalp Dama

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“…Transfer was defined for patients who were sent to other healthcare facilities for further therapy and rehabilitation. [ 10 ] Data validation was not performed and is planned as a part of the next step of the research. Some centers sent all their cases to the database, while some centers contributed a part of their data in a specific timeframe.…”

Section: Methodsmentioning

confidence: 99%

“…The first harvest of the CHSD was published in 2021 with the participation of 12 centers and 2,307 procedures. [10] In this second harvest, we aimed to analyze our current multicenter outcomes and compare them with the current results of international databases to reveal the areas that need improvement. We seek to encourage more national centers to participate in the project and to improve the potential for quality improvement.…”

Section: So Nuç: Bu çOk Merkezli Veritabanı çAlışması Ile Ilk Kezmentioning

confidence: 99%

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Second harvest of Congenital Heart Surgery Database in Türkiye: Current outcomes

Erek,

Başgöze,

Yıldız

et al. 2024

Turk Gogus Kalp Dama

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Background: This second harvest of the Congenital Heart Surgery Database intended to compare current results with international databases. Methods: This retrospective study examined a total of 4007 congenital heart surgery procedures from 15 centers in the Congenital Heart Surgery Database between January 2018 and January 2023. International diagnostic and procedural codes were used for data entry. STAT (Society of Thoracic Surgeons and European Association for Cardiothoracic Surgery) mortality scores and categories were used for comparison of the data. Surgical priority status was modified from American Society of Anesthesiologist guidelines. Centers that sent more than 5 cases to the database were included to the study. Results: Cardiopulmonary bypass and cardioplegic arrest were performed in 2,983 (74.4%) procedures. General risk factors were present in 22.6% of the patients, such as genetic anomaly, syndrome, or prematurity. Overall, 18.9% of the patients had preoperative risk factors (e.g., mechanical ventilation, renal failure, and sepsis). Of the procedures, 610 (15.2%) were performed on neonates, 1,450 (36.2%) on infants, 1,803 (45%) on children, and 144 (3.6%) on adults. The operative timing was elective in 56.5% of the patients, 34.4% were urgent, 8% were emergent, and 1.1% were rescue procedures. Extracorporeal membrane oxygenation support was used in 163 (4%) patients, with a 34.3% survival rate. Overall mortality in this series was 6.7% (n=271). Risk for mortality was higher in patients with general risk factors, such as prematurity, low birth weight neonates, and heterotaxy syndrome. Mortality for patients with preoperative mechanical ventilation was 17.5%. Pulmonary hypertension and preoperative circulatory shock had 11.6% and 10% mortality rates, respectively. Mortality for patients who had no preoperative risk factor was 3.9%. Neonates had the highest mortality rate (20.5%). Intensive care unit and hospital stay time for neonates (median of 17.8 days and 24.8 days, respectively) were also higher than the other age groups. Infants had 6.2% mortality. Hospital mortality was 2.8% for children and 3.5% for adults. Mortality rate was 2.8% for elective cases. Observed mortality rates were higher than expected in the fourth and fifth categories of the STAT system (observed, 14.8% and 51.9%; expected, 9.9% and 23.1%; respectively). Conclusion: For the first time, outcomes of congenital heart surgery in Türkiye could be compared to the current world experience with this multicenter database study. Increased mortality rate of neonatal and complex heart operations could be delineated as areas that need improvement. The Congenital Heart Surgery Database has great potential for quality improvement of congenital heart surgery in Türkiye. In the long term, participation of more centers in the database may allow more accurate risk adjustment.

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“…We sorted these 346 patients according to their protocol number and randomly selected 116 patients. Finally, we defined the patients' age, weight, sex, Modified Aristotle Comprehensive Complexity (MACC) score ( 12 ), biventricular repair, seizures, cardiopulmonary bypass (CPB) time, cross-clamping time, number of operations, and septicemia in the total cohort. A propensity score matching (PSM) analysis model was established using these variables with 1:1 matching and without sampling replacement.…”

Section: Methodsmentioning

confidence: 99%

The effect of extracorporeal membrane oxygenation on neurodevelopmental outcomes in children after repair of congenital heart disease: A pilot study from Turkey

et al. 2023

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BackgroundExtracorporeal membrane oxygenation (ECMO) is widely used after congenital heart surgery. The purpose of this study is to analyze the neurodevelopmental (ND) outcomes in patients who receivedECMO support after congenital cardiac surgery.MethodsBetween January 2014 and January 2021, 111 patients (5.8%) receivedECMO support after congenital heart operations, and 29 (26,1%) of these patients were discharged. Fifteen patients who met the inclusion criteria were included. A propensity score matching (PSM) analysis model was established using eight variables (age, weight, sex, Modified Aristotle Comprehensive Complexityscores, seizures, cardiopulmonary bypass duration, number of operations, and repair method) with 1:1 matching. According to the PSM model, 15 patients who underwent congenital heart operations were selected as the non-ECMO group. The Ages & Stages Questionnaire Third Edition (ASQ-3) was used for ND screening;it includes communication, physical skills (gross and fine motor), problem-solving, and personal–social skills domains.ResultsThere were no statistically significant differences between the patients' preoperative and postoperative characteristics. All patients were followed up for a median of 29 months (9–56 months). The ASQ-3 results revealed that communication, fine motor, and personal–social skills assessments were not statistically different between the groups. Gross motor skills (40 vs. 60), problem-solving skills (40 vs. 50), and overall scores (200 vs. 250) were better in the non-ECMO patients (P = 0.01, P = 0.03, and P = 0.03, respectively). Nine patients (%60) in the ECMO group and 3 patients (%20) in the non-ECMO group were with neurodevelopmental delay (P = 0,03).ConclusionND delay may occur in congenital heart surgery patients who receivedECMO support. We recommend ND screening in all patients with congenital heart disease, especially those who receivedECMO support.

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

Cited by 5 publications

References 22 publications

Outcomes of Norwood procedure with hypoplastic left heart syndrome: Our 12-year single-center experience

Outcomes of Norwood procedure with hypoplastic left heart syndrome: Our 12-year single-center experience

Second harvest of Congenital Heart Surgery Database in Türkiye: Current outcomes

The effect of extracorporeal membrane oxygenation on neurodevelopmental outcomes in children after repair of congenital heart disease: A pilot study from Turkey

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