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Related Experiment Video

Updated: Jan 14, 2026

Implantation of Total Artificial Heart in Congenital Heart Disease
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Understanding Mortality After Congenital Heart Surgery: What Do Procedure-Specific Factors Add?

Meena Nathan1, Larry Han2, Katya Zelevinsky3

  • 1Department of Cardiac Surgery, Boston Children's Hospital, Boston, Massachusetts; Department of Surgery, Harvard Medical School, Boston, Massachusetts.

The Annals of Thoracic Surgery
|October 23, 2025
PubMed
Summary
This summary is machine-generated.

Procedure-specific factors (PSFs) improve operative mortality models for some congenital heart surgeries. Not all PSFs are equally impactful, aiding in refining risk assessments and reducing data collection burdens.

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Area of Science:

  • Congenital Heart Surgery
  • Cardiovascular Surgery
  • Health Services Research

Background:

  • The Society of Thoracic Surgeons Congenital Heart Surgery Database (STS-CHSD) collects data, but the value of procedure-specific factors (PSFs) for predicting mortality is unstudied.
  • This study evaluates the contribution of PSFs to understanding expected mortality in a large cohort.

Purpose of the Study:

  • To assess the impact of procedure-specific factors (PSFs) on operative mortality discrimination.
  • To identify which specific PSFs most significantly influence mortality estimates in benchmark operations (BMOs).

Main Methods:

  • Utilized data from 115 US centers (2016-2022) for benchmark operations (BMOs) with captured PSFs.
  • Compared a baseline risk model with a model incorporating PSFs using advanced statistical methods.
  • Analyzed model discrimination and the impact of individual PSFs, stratified by BMO.

Main Results:

  • Operative mortality was 2.6% across 37,282 BMOs.
  • Model discrimination improved from 0.088 (baseline) to 0.095 (baseline + PSF) overall, with enhanced discrimination for 5 of 9 BMOs.
  • PSF impact varied by BMO; Norwood and truncus arteriosus repair retained the most PSFs, while ventricular septal defect retained none.

Conclusions:

  • Incorporating PSFs into expected mortality models enhances discrimination for certain BMOs.
  • Specific PSFs significantly impact mortality estimates, while others do not.
  • Findings can reduce data collection burden and refine risk models for congenital heart surgery.