The Society of Thoracic Surgeons Adult Cardiac Surgery Database: 2019 Update on Outcomes and Quality

D’Agostino, Richard S.; Jacobs, Jeffrey P.; Badhwar, Vinay; Fernández, Félix G.; Paone, Gaetano; Wormuth, David W.; Shahian, David M.

doi:10.1016/j.athoracsur.2018.10.004

Cited by 192 publications

(154 citation statements)

References 32 publications

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“…Therefore, it is essential to understand the profile of patients with VHD in our country to delineate adequate strategies for health promotion and allocation of resources for cardiac surgery. Following the establishment of the Society of Thoracic Surgeons (STS) Adult Cardiac Surgery Database, in 1989, to address the shortcomings of coronary artery bypass grafting (CABG) mortality data, many other national and continental databases were instituted to gather information on current trends and improve the quality assessment and advance of cardiovascular surgery in their respective areas [2] .…”

Section: Introductionmentioning

confidence: 99%

Valve Heart Surgery in Brazil – The BYPASS Registry Analysis

Zilli¹,

Guizilini²,

Rocco³

et al. 2020

Braz J Cardiovasc Surg

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Objective: To analyze the profile and outcomes of patients who underwent valve heart surgery in Brazil, using information retrieved from the Brazilian Registry of Cardiovascular Surgeries in Adults (BYPASS Registry) database.Methods: This is a multicenter cohort study, evaluating 920 patients submitted to heart valve surgery. Demographics and postoperative clinical outcomes were assessed and compared to estimate mortality risk using the European System for Cardiac Operative Risk Evaluation (EuroSCORE).Results: Isolated aortic valve replacement was the most frequently performed surgery (34%), followed by isolated mitral valve replacement (24.9%). Valve repair was performed in 21% of mitral procedures. Minimally invasive access was performed in 1.6% and the most frequent postoperative complications were arrhythmias (22.6%), infections (5.7%), and low-output syndrome (5.1%). Operations covered by the public health system accounted for 80.8% and the hospital mortality rate was 7.3%.Conclusion: The most frequent isolated valve surgery in Brazil is the aortic valve replacement by conventional open access and the rheumatic disease is still the main etiology for valve surgery. The BYPASS Registry has a fundamental role to provide information on the profile of patients with valve heart disease in our country in order to delineate adequate strategies for health promotion and resource allocation for cardiac surgery.

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Section: Introductionmentioning

confidence: 99%

Valve Heart Surgery in Brazil – The BYPASS Registry Analysis

Zilli¹,

Guizilini²,

Rocco³

et al. 2020

Braz J Cardiovasc Surg

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“…The perioperative outcomes after kidney transplantation further worsened in patients with suboptimal cardiac function . Similarly, cardiac surgery may lead to impaired renal function even in the presence of normal renal function . The adverse renal outcome could be exaggerated in patients with already impaired renal function, and the optimum cardiovascular function may be difficult to achieve after cardiac surgery in these patients .…”

Section: Clinical Decision‐making: Processes and Problemsmentioning

confidence: 99%

“…23 Similarly, cardiac surgery may lead to impaired renal function even in the presence of normal renal function. 24 The adverse renal outcome could be exaggerated in patients with already impaired renal function, and the optimum cardiovascular function may be difficult to achieve after cardiac surgery in these patients. [25][26][27] The clinical practice guideline of ACC/AHA (American College of Cardiology/American Heart Association) on non-cardiac surgery has not specifically addressed the kidney transplantation candidate.…”

Section: Clinic Al Decis Ion -Making : Pro Ce Ss E S and Prob Lemsmentioning

confidence: 99%

Kidney transplantation and cardiomyopathy: Concepts and controversies in clinical decision‐making

Jha

Lata

2020

Clinical Transplantation

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Increasing comorbidities and an aging population have led to a tremendous increase in the burden of both kidney and cardiac dysfunction. Concomitant cardiomyopathy exposes the patients with kidney disease to further physiological, hemodynamic, and pathologic alterations. Kidney transplantation imposes lesser anesthetic and surgical complexities compared to another solid organ transplant. The surgical decision‐making remains an unsettled issue in these conditions. The surgical choices, techniques, and sequences in kidney transplant and cardiac surgery depend on the pathophysiological perturbations and perioperative outcomes. The absence of randomized controlled trials eludes us from suggesting definite management protocol in patients with end‐stage kidney disease with cardiomyopathy. Nevertheless, in this review, we extracted data from published literature to understand the pathophysiologic interactions between end‐stage renal diseases with cardiomyopathy and also proposed the management algorithm in this challenging scenario. The proposed management algorithm would ensure consensus across all stakeholders involved in decision‐making. Our simplistic evidence‐based approach would augur future randomized trials and would further ensure refinement in our management approach after the emergence of more definitive evidence.

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“…A cirurgia cardiovascular tem sofrido transformações ao longo da sua história, principalmente após a consolidação dos grandes bancos de dados. 1 Essas informações ajudaram a reduzir a mortalidade cirúrgica através da implementação de melhorias orientadas por dados. 2 Na época, essa era a realidade de poucos centros no mundo.…”

Section: Introductionunclassified

Análise de >100.000 Cirurgias Cardiovasculares Realizadas no Instituto do Coração e a Nova Era com Foco nos Resultados

et al. 2020

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ResumoFundamento: O desafio atual da cirurgia cardiovascular (CCV) é melhorar resultados em pacientes cada vez mais graves. Nesse sentido, Programas de Melhoria Contínua da Qualidade (PMCQ) tem impactado os resultados. Objetivo: Avaliar a evolução da incidência e mortalidade das CCV, assim como os resultados atuais do Instituto do A análise incluiu o total de cirurgias e a evolução dos procedimentos mais frequentes.Resultados: Foram realizadas 105.599 CCV, com uma média anual de 2.964 procedimentos e mortalidade de 5,63%. Comparando o 4° com o 5° período, o volume global médio de cirurgias foi de 2.943 para 3.139 (p = 0,368), cirurgias de revascularização miocárdica (CRM) de 638 para 597 (p = 0,214), valvas cardíacas de 372 para 465 (p = 0,201) e cardiopatias congênitas de 530 para 615 (p = 0,125). A mortalidade média global passou de 7,8% para 5% (p < 0,0001), nas cirurgias de revascularização miocárdica de 5,8% para 3,1% (p < 0,0001), nas cirurgias valvares de 14% para 7,5% (p < 0,0001) e nas cirurgias de cardiopatias congênitas de 12,1% para 9,6% (p < 0,0001). Conclusão: Embora haja uma tendência recente ao aumento dos volumes cirúrgicos, houve uma diminuição significativa da mortalidade cirúrgica nos grupos analisados. Após o estabelecimento do PMCQ, as taxas de mortalidade se aproximaram a dos padrões internacionais. (Arq Bras Cardiol. 2020; [online].ahead print, PP.0-0) Palavras-chave: Procedimentos Cirúrgicos Cardiovasculares/tendências; Melhoria de Qualidade; Segurança do Paciente; Mortalidade Hospitalar; Banco de Dados. AbstractBackground: The current challenge of cardiovascular surgery (CVS) is to improve the outcomes in increasingly severe patients. In this respect, continuous quality improvement (CQI) programs have had an impact on outcomes.Objective: To assess the evolution of the incidence and mortality due to CVS, as well as the current outcomes of the Hospital das Clínicas Heart ). The CQI program was implemented between 2015 and 2016. The analysis included the total number of surgeries and the evolution of the most frequent procedures.Results: A total of 105,599 CCVs were performed, with an annual mean of 2,964 procedures and mortality of 5,63%. When comparing the 4th and the 5th periods, the average global volume of surgeries was increased from 2,943 to 3,139 (p = 0.368), bypass graft (CABG), from 638 to 597 (p = 0.214), heart valve surgery, from 372 to 465 (p = 0.201), and congenital heart disease surgery, from 530 to 615 (p = 0.125). The average global mortality went from 7.8% to 5% (p < 0.0001); in CABG surgery, from 5.8% to 3.1% (p < 0.0001); in heart valve surgery, from 14% to 7.5% (p < 0.0001) and in congenital heart disease surgery, from 12.1% to 9.6% (p < 0.0001). Conclusion:In spite of a recent trend towards increased surgical volume, there was a significant decrease in operative mortality in the groups studied. After the implementation of the CQI program, the mortality rates were closer to international standards. (Arq Bras Cardiol. 2020; [online].ahead print, PP.0-0)

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The Society of Thoracic Surgeons Adult Cardiac Surgery Database: 2019 Update on Outcomes and Quality

Cited by 192 publications

References 32 publications

Valve Heart Surgery in Brazil – The BYPASS Registry Analysis

Valve Heart Surgery in Brazil – The BYPASS Registry Analysis

Kidney transplantation and cardiomyopathy: Concepts and controversies in clinical decision‐making

Análise de >100.000 Cirurgias Cardiovasculares Realizadas no Instituto do Coração e a Nova Era com Foco nos Resultados

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