Evidence map›Paper›PMID 38936590›Full record

ArticleThe Annals of thoracic surgery2024

Risk of Cardiac Reoperation: An Analysis of The Society of Thoracic Surgeons Congenital Heart Surgery Database.

Elaine M Griffeth, Elizabeth H Stephens, Luke J Burchill, Jonathan N Johnson, Sheri Crow, Jeffrey P Jacobs, Marshall L Jacobs, Austin Todd, Joseph A Dearani

Abstract readMulticenter Study
In one paragraph

Article in The Annals of thoracic surgery, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Elaine M GriffethDepartment of Cardiovascular Surgery, Mayo Clinic, Rochester, Minnesota.
Elizabeth H StephensDepartment of Cardiovascular Surgery, Mayo Clinic, Rochester, Minnesota.
Luke J BurchillDivision of Structural Heart Disease, Mayo Clinic, Rochester, Minnesota.
Jonathan N JohnsonDivision of Pediatric Cardiology, Mayo Clinic, Rochester, Minnesota.
Sheri CrowDepartment of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota.
Jeffrey P JacobsDivision of Thoracic and Cardiovascular Surgery, University of Florida, Gainesville, Florida.
Marshall L JacobsDivision of Cardiac Surgery, Johns Hopkins, Baltimore, Maryland.
Austin ToddDepartment of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota.
Joseph A DearaniDepartment of Cardiovascular Surgery, Mayo Clinic, Rochester, Minnesota. Electronic address: jdearani@mayo.edu.

Funding

Mayo Clinic StARR ProgramR38HL150086 · NHLBI · MAYO CLINIC ROCHESTER · PI VESNA D GAROVIC, KARL A. NATH · 2020 to 2026
$2.5M
NHLBI NIH HHS R38 HL150086
6 · The paper itself

Abstract

backgroundThe increasing number of congenital heart disease patients undergoing reoperative cardiac surgery presents critical and growing challenges. Our objective was to evaluate the association between the number of prior cardiopulmonary bypass operations and operative mortality and morbidity in a national cohort.

methodsThe Society of Thoracic Surgeons Congenital Heart Surgery Database (STS-CHSD) was reviewed for index cardiac operations on cardiopulmonary bypass during 2016 to 2021. Infants and patients with functionally univentricular physiology were excluded. Multivariable logistic regression adjusted for covariates in the STS-CHSD Mortality Risk Model, the STS-European Association for Cardio-Thoracic Surgery (STAT) Mortality Category, and institutional volume.

resultsOf 50,625 eligible operations, 22,100 (44%) were performed on patients with ≥1 prior cardiopulmonary bypass operations. Most common diagnoses were tetralogy of Fallot (4340 of 22,100 [19.6%]), pulmonary atresia/ventricular septal defect (1334 of 22,100 [6.0%]), and aortic stenosis (966 of 22,100 [4.4%]). Operative mortality correlated with number of prior cardiopulmonary bypass operations: 157 of 28,525 (0.6%) for 0, 127 of 13,488 (0.9%) for 1, 81 of 5,664 (1.4%) for 2, 61 of 2039 (3.0%) for 3, 35 of 623 (5.6%) for 4, 10 of 207 (4.8%) for 5, and 5 of 79 (6.3%) for ≥6 operations (P < .001). On multivariable analysis, patients with ≥3 prior cardiopulmonary bypass operations had higher risk of operative mortality (odds ratio, 2.31; P < .001) and major morbidity (odds ratio, 1.60; P < .001). Annual institutional volume and age were not associated with either outcome.

conclusionsThree or more prior cardiopulmonary bypass operations was an independent risk factor for operative mortality/morbidity, even after controlling for risk factors and institutional volume. Future research is needed to identify modifiable factors to optimize outcomes, particularly for those with ≥3 prior cardiopulmonary bypass operations.

Indexed as

Cardiac Surgical ProceduresDatabases, FactualHeart Defects, CongenitalReoperationSocieties, MedicalThoracic SurgeryAdolescentCardiopulmonary BypassChildChild, PreschoolFemaleHumansInfantInfant, NewbornMalePostoperative Complications

Identifiers

PMID38936590
PMCPMC11513241

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.