Observational studyJournal of the American College of Cardiology2021
Impact of Major Residual Lesions on Outcomes After Surgery for Congenital Heart Disease.
Observational study in Journal of the American College of Cardiology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers.
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Who cites it
21 citing papers in PubMed.
- Reexploring the STRESS Trial: Subgroup Postoperative Outcomes Following Methylprednisolone for Infant Heart Surgery.Pediatric cardiology · 2026Trial
- Trial
- Acuity of Patients Undergoing Congenital Heart Surgery During Hospitalization.Journal of the American Heart Association · 2026Article
- Early and Midterm Reintervention in Valve-Sparing Tetralogy of Fallot Repair: Role of Residual Lesion Score.Pediatric cardiology · 2026Article
- Immune Unresponsiveness to Cardiopulmonary Bypass Is Associated With Unfavorable Outcome in Infants Requiring Cardiac Surgery.JACC. Basic to translational science · 2026Article
- Interventions for adult congenital heart disease.Nature reviews. Cardiology · 2025Review
- Days Alive Out of Health Care: A Novel Measure of Health Status After Congenital Heart Surgery.Journal of the American College of Cardiology · 2025Article
- Evaluating Procedural Performance: A Composite Outcome for Atrial Septal Defect and Patent Ductus Arteriosus Closures.Journal of the Society for Cardiovascular Angiography & Interventions · 2025Article
- Enhancing Quality of Congenital Heart Care Within Resource-Limited Settings.Pediatric cardiology · 2025Review
- Impact of Residual Lesion Severity on Neurodevelopmental Outcomes Following Congenital Heart Surgery in Infancy and Childhood.Pediatric cardiology · 2024Article
- Trisomy 21 and Congenital Heart Disease: Impact on Health and Functional Outcomes From Birth Through Adolescence: A Scientific Statement From the American Heart Association.Journal of the American Heart Association · 2024Review
- Days alive and out of hospital for children born with single-ventricle heart disease.Cardiology in the young · 2024Article
- Intraoperative characterization of cardiac tissue: the potential of light scattering spectroscopy.Journal of biomedical optics · 2024Article
- Echocardiographic image collection and evaluation in infants with CHD: lessons learned from the imaging core lab for the Residual Lesion Score study.Cardiology in the young · 2024Article
- Technical performance scores associate with early prognosis of tetralogy of Fallot repair.Frontiers in pediatrics · 2024Article
- Recommendations for developing effective and safe paediatric and congenital heart disease services in low-income and middle-income countries: a public health framework.BMJ global health · 2023Article
- Impact of Neighborhood Socioeconomic Status on Outcomes Following First-Stage Palliation of Single Ventricle Heart Disease.Journal of the American Heart Association · 2023Article
- Whole exome sequencing identifies novel inherited genetic variants in tetralogy of Fallot.Journal of thoracic disease · 2022Article
- Cost Containment in the Single Ventricle Population.JACC. Advances · 2022Article
- Editorial: Neonatal ECMO in 2019: Where Are We Now? Where Next?Frontiers in pediatrics · 2021Article
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30 authors.
Funding
Abstract
backgroundMany factors affect outcomes after congenital cardiac surgery.
objectivesThe RLS (Residual Lesion Score) study explored the impact of severity of residual lesions on post-operative outcomes across operations of varying complexity.
methodsIn a prospective, multicenter, observational study, 17 sites enrolled 1,149 infants undergoing 5 common operations: tetralogy of Fallot repair (n = 250), complete atrioventricular septal defect repair (n = 249), arterial switch operation (n = 251), coarctation or interrupted arch with ventricular septal defect (VSD) repair (n = 150), and Norwood operation (n = 249). The RLS was assigned based on post-operative echocardiography and clinical events: RLS 1 (trivial or no residual lesions), RLS 2 (minor residual lesions), or RLS 3 (reintervention for or major residual lesions before discharge). The primary outcome was days alive and out of hospital within 30 post-operative days (60 for Norwood). Secondary outcomes assessed post-operative course, including major medical events and days in hospital.
resultsRLS 3 (vs. RLS 1) was an independent risk factor for fewer days alive and out of hospital (p ≤ 0.008) and longer post-operative hospital stay (p ≤ 0.02) for all 5 operations, and for all secondary outcomes after coarctation or interrupted arch with VSD repair and Norwood (p ≤ 0.03). Outcomes for RLS 1 versus 2 did not differ consistently. RLS alone explained 5% (tetralogy of Fallot repair) to 20% (Norwood) of variation in the primary outcome.
conclusionsAdjusting for pre-operative factors, residual lesions after congenital cardiac surgery impacted in-hospital outcomes across operative complexity with greatest impact following complex operations. Minor residual lesions had minimal impact. These findings may provide guidance for surgeons when considering short-term risks and benefits of returning to bypass to repair residual lesions.
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