Current Practices in the Timing of Stage 2 Palliation

Congenital Heart Surgeons’ Society

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

BACKGROUND: Mortality through single-ventricle palliation remains high and the effect of the timing of stage 2 palliation (S2P) is not well understood. We investigated current practice patterns in the timing of S2P across two professional societies and compared them to actual practice patterns from two databases of patients who underwent S2P.

METHODS: A ten-question survey was distributed to the members of the Congenital Heart Surgeons' Society (CHSS) and the European Congenital Heart Surgeons' Association (ECHSA). Results were summarized using descriptive statistics. Surgeon-reported preferences were compared to clinical data from the CHSS Critical Left Ventricular Outflow Tract Obstruction (LVOTO) Registry and the Pediatric Heart Network Single Ventricle Reconstruction (SVR) database.

RESULTS: Overall, 38% (88 of 232) of surgeons from 74 institutions responded, of which 70% (62 of 88) were CHSS members and 30% (26 of 88) were ECHSA members. Surgeons reported performing S2P at a median of five months after stage 1 (interquartile range [IQR]: 4.5-6), with no difference between CHSS and ECHSA surgeons. Surgeons reported performing nonelective S2P at a median of 4.5 months after stage 1 (IQR: 3.5-5.5), again with no difference by society. No difference existed between the surgeon-reported preferences and patient data in the Critical LVOTO and SVR databases for the timing of elective (5 vs 5.1 vs 5.3 months, P = .19) or nonelective S2P (4.5 vs 4.6 vs 4.2 months, P = .06).

CONCLUSION: There was a remarkable lack of variation in surgeon preferences regarding the timing of S2P. This may represent a natural standardization of practice across congenital heart surgery, which is notable, given the current lack of guidelines regarding the timing of S2P.

Original languageEnglish (US)
Pages (from-to)135-141
Number of pages7
JournalWorld journal for pediatric & congenital heart surgery
Volume8
Issue number2
DOIs
StatePublished - Mar 1 2017

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Ventricular Outflow Obstruction
Databases
Surgeons
Patient Preference
Thoracic Surgery
Registries
Guidelines
Pediatrics
Mortality
Surveys and Questionnaires

Keywords

  • cavopulmonary anastamosis
  • congenital heart surgery
  • database
  • hypoplastic left heart syndrome

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Current Practices in the Timing of Stage 2 Palliation. / Congenital Heart Surgeons’ Society.

In: World journal for pediatric & congenital heart surgery, Vol. 8, No. 2, 01.03.2017, p. 135-141.

Research output: Contribution to journalArticle

Congenital Heart Surgeons’ Society. / Current Practices in the Timing of Stage 2 Palliation. In: World journal for pediatric & congenital heart surgery. 2017 ; Vol. 8, No. 2. pp. 135-141.
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abstract = "BACKGROUND: Mortality through single-ventricle palliation remains high and the effect of the timing of stage 2 palliation (S2P) is not well understood. We investigated current practice patterns in the timing of S2P across two professional societies and compared them to actual practice patterns from two databases of patients who underwent S2P.METHODS: A ten-question survey was distributed to the members of the Congenital Heart Surgeons' Society (CHSS) and the European Congenital Heart Surgeons' Association (ECHSA). Results were summarized using descriptive statistics. Surgeon-reported preferences were compared to clinical data from the CHSS Critical Left Ventricular Outflow Tract Obstruction (LVOTO) Registry and the Pediatric Heart Network Single Ventricle Reconstruction (SVR) database.RESULTS: Overall, 38{\%} (88 of 232) of surgeons from 74 institutions responded, of which 70{\%} (62 of 88) were CHSS members and 30{\%} (26 of 88) were ECHSA members. Surgeons reported performing S2P at a median of five months after stage 1 (interquartile range [IQR]: 4.5-6), with no difference between CHSS and ECHSA surgeons. Surgeons reported performing nonelective S2P at a median of 4.5 months after stage 1 (IQR: 3.5-5.5), again with no difference by society. No difference existed between the surgeon-reported preferences and patient data in the Critical LVOTO and SVR databases for the timing of elective (5 vs 5.1 vs 5.3 months, P = .19) or nonelective S2P (4.5 vs 4.6 vs 4.2 months, P = .06).CONCLUSION: There was a remarkable lack of variation in surgeon preferences regarding the timing of S2P. This may represent a natural standardization of practice across congenital heart surgery, which is notable, given the current lack of guidelines regarding the timing of S2P.",
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author = "{Congenital Heart Surgeons’ Society} and Meza, {James M.} and Jaquiss, {Robert Douglas Benjamin} and Anderson, {Brett R.} and Moga, {Michael Alice} and Kirklin, {James K.} and George Sarris and Williams, {William G.} and McCrindle, {Brian W.}",
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AU - Jaquiss, Robert Douglas Benjamin

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AU - Moga, Michael Alice

AU - Kirklin, James K.

AU - Sarris, George

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AU - McCrindle, Brian W.

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