TY - JOUR
T1 - Current Practices in the Timing of Stage 2 Palliation
T2 - A Survey of the CHSS and ECHSA
AU - on behalf of the Congenital Heart Surgeons’ Society
AU - Meza, James M.
AU - Jaquiss, Robert D.B.
AU - Anderson, Brett R.
AU - Moga, Michael Alice
AU - Kirklin, James K.
AU - Sarris, George
AU - Williams, William G.
AU - McCrindle, Brian W.
N1 - Publisher Copyright:
© 2016, © The Author(s) 2016.
PY - 2017/3/1
Y1 - 2017/3/1
N2 - 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.
AB - 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.
KW - cavopulmonary anastamosis
KW - congenital heart surgery
KW - database
KW - hypoplastic left heart syndrome
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U2 - 10.1177/2150135116677253
DO - 10.1177/2150135116677253
M3 - Article
C2 - 28329463
AN - SCOPUS:85053527518
SN - 2150-1351
VL - 8
SP - 135
EP - 141
JO - World Journal for Pediatric and Congenital Heart Surgery
JF - World Journal for Pediatric and Congenital Heart Surgery
IS - 2
ER -