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The Society of Thoracic Surgeons Congenital Heart Surgery Database: 2019 Update on Outcomes and Quality

Jeffrey P Jacobs1, John E Mayer2, Sara K Pasquali3

  • 1Division 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, Johns Hopkins All Children's Hospital and Florida Hospital for Children, Saint Petersburg, Tampa, and Orlando, Florida.

The Annals of Thoracic Surgery
|January 15, 2019
PubMed

Insights

The Society of Thoracic Surgeons Congenital Heart Surgery Database reports national outcomes for pediatric cardiac surgery. Operative mortality rates vary by procedure, with complex operations like the Norwood procedure having higher mortality.

Area of Science:

  • Pediatric Cardiac Surgery
  • Clinical Outcomes Research
  • Quality Improvement in Healthcare

Background:

  • The Society of Thoracic Surgeons Congenital Heart Surgery Database (STS-CHSD) is a key registry for pediatric cardiac surgical operations in the US.
  • It serves as the foundation for analyzing outcomes and enhancing quality in congenital heart surgery.
  • This report focuses on aggregate national outcomes and related quality initiatives.

Purpose of the Study:

  • To summarize current aggregate national outcomes in congenital and pediatric cardiac surgery.
  • To review activities in quality measurement, performance improvement, and transparency within the STS-CHSD.
  • To provide benchmark data for 10 common congenital heart operations.

Main Methods:

  • Analysis of data from the Society of Thoracic Surgeons Congenital Heart Surgery Database.
  • Inclusion of data from North American participants between January 2014 and December 2017.
  • Calculation of aggregate Operative Mortality and interquartile range (IQR) for specific benchmark procedures.

Main Results:

  • Operative Mortality rates for 10 benchmark procedures were reported, with examples including:
  • - Off-bypass coarctation repair: 1.5% (IQR, 0.0% to 1.4%)
  • - Ventricular septal defect repair: 0.5% (IQR, 0.0% to 0.5%)
  • - Tetralogy of Fallot repair: 1.3% (IQR, 0.0% to 2.0%)
  • - Norwood (stage 1) operation: 15.0% (IQR, 8.3% to 25.0%)

Conclusions:

  • The STS-CHSD provides valuable aggregate national outcome data for pediatric cardiac surgery.
  • Mortality rates vary significantly across different congenital heart surgical procedures.
  • This data supports ongoing efforts in quality measurement and performance improvement in the field.

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