Cardiac surgery in adults with high-surgical complexity CHD: Results of a network collaborative programme

Vered Gilad, Francesco Santoro, Elena Ribera, Maria G. Calevo, Adriano Cipriani, Achille Pasquè, Sergio L. Chierchia

Research output: Contribution to journalArticle

Abstract

Background Adults with CHD often exhibit complex cardiac abnormalities, whose management requires specific clinical and surgical expertise. To enable easier access of these patients to highly specialised care, we implemented a collaborative programme that incorporates medical and surgical specialists belonging to both paediatric and adult cardiovascular institutions. Objectives The objective of this study was to review the experience gained and to analyse the surgical outcome of major cardiac surgery. Methods We retrospectively reviewed all consecutive patients admitted for major cardiac surgery using our network between January, 2010 and December, 2013. Analysis of surgical outcome was performed in patients selected for major cardiac surgery with cardiopulmonary bypass. Early and late outcomes were evaluated. Results Out of a total of 433 inward patients, 86 were selected for surgery. The median age was 25.5 years, -64 patients (74.4%) had previously undergone heart surgery, and -55 patients (64%) had been subjected to at least one sternotomy. Abnormalities of the left ventricular and right ventricular outflow tract were the most frequent (37.2% and 30.2%, respectively), and despite high-surgical complexity only one death occurred (in-hospital mortality 1.1%). On a median follow-up time of 4 years no deaths and no heart-failure events have occurred; one patient underwent further cardiac surgery programmed at the time of discharge. Conclusions Low mortality and morbidity rates can be obtained in high-surgical complexity adults with CHD populations when paediatric and adult cardiac specialists operate in the same multidisciplinary environment.

Original languageEnglish
Pages (from-to)101-107
Number of pages7
JournalCardiology in the Young
Volume28
Issue number1
DOIs
Publication statusPublished - Jan 1 2018

Fingerprint

Thoracic Surgery
Pediatrics
Sternotomy
Hospital Mortality
Cardiopulmonary Bypass
Heart Failure
Morbidity
Mortality
Population

Keywords

  • Adult
  • cardiac surgery
  • CHD
  • organisation model

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Cardiology and Cardiovascular Medicine

Cite this

Cardiac surgery in adults with high-surgical complexity CHD : Results of a network collaborative programme. / Gilad, Vered; Santoro, Francesco; Ribera, Elena; Calevo, Maria G.; Cipriani, Adriano; Pasquè, Achille; Chierchia, Sergio L.

In: Cardiology in the Young, Vol. 28, No. 1, 01.01.2018, p. 101-107.

Research output: Contribution to journalArticle

Gilad, Vered ; Santoro, Francesco ; Ribera, Elena ; Calevo, Maria G. ; Cipriani, Adriano ; Pasquè, Achille ; Chierchia, Sergio L. / Cardiac surgery in adults with high-surgical complexity CHD : Results of a network collaborative programme. In: Cardiology in the Young. 2018 ; Vol. 28, No. 1. pp. 101-107.
@article{2bd6dc29238c4541b270712103eeed72,
title = "Cardiac surgery in adults with high-surgical complexity CHD: Results of a network collaborative programme",
abstract = "Background Adults with CHD often exhibit complex cardiac abnormalities, whose management requires specific clinical and surgical expertise. To enable easier access of these patients to highly specialised care, we implemented a collaborative programme that incorporates medical and surgical specialists belonging to both paediatric and adult cardiovascular institutions. Objectives The objective of this study was to review the experience gained and to analyse the surgical outcome of major cardiac surgery. Methods We retrospectively reviewed all consecutive patients admitted for major cardiac surgery using our network between January, 2010 and December, 2013. Analysis of surgical outcome was performed in patients selected for major cardiac surgery with cardiopulmonary bypass. Early and late outcomes were evaluated. Results Out of a total of 433 inward patients, 86 were selected for surgery. The median age was 25.5 years, -64 patients (74.4{\%}) had previously undergone heart surgery, and -55 patients (64{\%}) had been subjected to at least one sternotomy. Abnormalities of the left ventricular and right ventricular outflow tract were the most frequent (37.2{\%} and 30.2{\%}, respectively), and despite high-surgical complexity only one death occurred (in-hospital mortality 1.1{\%}). On a median follow-up time of 4 years no deaths and no heart-failure events have occurred; one patient underwent further cardiac surgery programmed at the time of discharge. Conclusions Low mortality and morbidity rates can be obtained in high-surgical complexity adults with CHD populations when paediatric and adult cardiac specialists operate in the same multidisciplinary environment.",
keywords = "Adult, cardiac surgery, CHD, organisation model",
author = "Vered Gilad and Francesco Santoro and Elena Ribera and Calevo, {Maria G.} and Adriano Cipriani and Achille Pasqu{\`e} and Chierchia, {Sergio L.}",
year = "2018",
month = "1",
day = "1",
doi = "10.1017/S1047951117001664",
language = "English",
volume = "28",
pages = "101--107",
journal = "Cardiology in the Young",
issn = "1047-9511",
publisher = "Cambridge University Press",
number = "1",

}

TY - JOUR

T1 - Cardiac surgery in adults with high-surgical complexity CHD

T2 - Results of a network collaborative programme

AU - Gilad, Vered

AU - Santoro, Francesco

AU - Ribera, Elena

AU - Calevo, Maria G.

AU - Cipriani, Adriano

AU - Pasquè, Achille

AU - Chierchia, Sergio L.

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Background Adults with CHD often exhibit complex cardiac abnormalities, whose management requires specific clinical and surgical expertise. To enable easier access of these patients to highly specialised care, we implemented a collaborative programme that incorporates medical and surgical specialists belonging to both paediatric and adult cardiovascular institutions. Objectives The objective of this study was to review the experience gained and to analyse the surgical outcome of major cardiac surgery. Methods We retrospectively reviewed all consecutive patients admitted for major cardiac surgery using our network between January, 2010 and December, 2013. Analysis of surgical outcome was performed in patients selected for major cardiac surgery with cardiopulmonary bypass. Early and late outcomes were evaluated. Results Out of a total of 433 inward patients, 86 were selected for surgery. The median age was 25.5 years, -64 patients (74.4%) had previously undergone heart surgery, and -55 patients (64%) had been subjected to at least one sternotomy. Abnormalities of the left ventricular and right ventricular outflow tract were the most frequent (37.2% and 30.2%, respectively), and despite high-surgical complexity only one death occurred (in-hospital mortality 1.1%). On a median follow-up time of 4 years no deaths and no heart-failure events have occurred; one patient underwent further cardiac surgery programmed at the time of discharge. Conclusions Low mortality and morbidity rates can be obtained in high-surgical complexity adults with CHD populations when paediatric and adult cardiac specialists operate in the same multidisciplinary environment.

AB - Background Adults with CHD often exhibit complex cardiac abnormalities, whose management requires specific clinical and surgical expertise. To enable easier access of these patients to highly specialised care, we implemented a collaborative programme that incorporates medical and surgical specialists belonging to both paediatric and adult cardiovascular institutions. Objectives The objective of this study was to review the experience gained and to analyse the surgical outcome of major cardiac surgery. Methods We retrospectively reviewed all consecutive patients admitted for major cardiac surgery using our network between January, 2010 and December, 2013. Analysis of surgical outcome was performed in patients selected for major cardiac surgery with cardiopulmonary bypass. Early and late outcomes were evaluated. Results Out of a total of 433 inward patients, 86 were selected for surgery. The median age was 25.5 years, -64 patients (74.4%) had previously undergone heart surgery, and -55 patients (64%) had been subjected to at least one sternotomy. Abnormalities of the left ventricular and right ventricular outflow tract were the most frequent (37.2% and 30.2%, respectively), and despite high-surgical complexity only one death occurred (in-hospital mortality 1.1%). On a median follow-up time of 4 years no deaths and no heart-failure events have occurred; one patient underwent further cardiac surgery programmed at the time of discharge. Conclusions Low mortality and morbidity rates can be obtained in high-surgical complexity adults with CHD populations when paediatric and adult cardiac specialists operate in the same multidisciplinary environment.

KW - Adult

KW - cardiac surgery

KW - CHD

KW - organisation model

UR - http://www.scopus.com/inward/record.url?scp=85038416819&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85038416819&partnerID=8YFLogxK

U2 - 10.1017/S1047951117001664

DO - 10.1017/S1047951117001664

M3 - Article

C2 - 28847320

AN - SCOPUS:85038416819

VL - 28

SP - 101

EP - 107

JO - Cardiology in the Young

JF - Cardiology in the Young

SN - 1047-9511

IS - 1

ER -