Doctors' judgements of the likelihood of early mortality following paediatric cardiac surgery

1998 ◽  
Author(s):  
Tim Rakow ◽  
Nigel Harvey
Keyword(s):  
Cardiac Surgery ◽  
Early Mortality ◽  
Paediatric Cardiac Surgery

scholarly journals What are the important morbidities associated with paediatric cardiac surgery? A mixed methods study

BMJ Open ◽  
2019 ◽  
Vol 9 (9) ◽  
pp. e028533 ◽  
Author(s):  
Katherine L Brown ◽  
Christina Pagel ◽  
Deborah Ridout ◽  
Jo Wray ◽  
David Anderson ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Mixed Methods ◽  
Life Support ◽  
Extracorporeal Life Support ◽  
Early Mortality ◽  
Mixed Methods Study ◽  
Feeding Problems ◽  
Safety Outcome ◽  
Paediatric Cardiac Surgery ◽  
The Impact

ObjectivesGiven the current excellent early mortality rates for paediatric cardiac surgery, stakeholders believe that this important safety outcome should be supplemented by a wider range of measures. Our objectives were to prospectively measure the incidence of morbidities following paediatric cardiac surgery and to evaluate their clinical and health-economic impact over 6 months.DesignThe design was a prospective, multicentre, multidisciplinary mixed methods study.SettingThe setting was 5 of the 10 paediatric cardiac surgery centres in the UK with 21 months recruitment.ParticipantsIncluded were 3090 paediatric cardiac surgeries, of which 666 patients were recruited to an impact substudy.ResultsFamilies and clinicians prioritised:Acute neurological event, unplanned re-intervention, feeding problems, renal replacement therapy, major adverse events, extracorporeal life support, necrotising enterocolitis, postsurgical infection and prolonged pleural effusion or chylothorax.Among 3090 consecutive surgeries, there were 675 (21.8%) with at least one of these morbidities. Independent risk factors for morbidity included neonatal age, complex heart disease and prolonged cardiopulmonary bypass (p<0.001). Among patients with morbidity, 6-month survival was 88.2% (95% CI 85.4 to 90.6) compared with 99.3% (95% CI 98.9 to 99.6) with none of the morbidities (p<0.001). The impact substudy in 340 children with morbidity and 326 control children with no morbidity indicated that morbidity-related impairment in quality of life improved between 6 weeks and 6 months. When compared with children with no morbidities, those with morbidity experienced a median of 13 (95% CI 10.2 to 15.8, p<0.001) fewer days at home by 6 months, and an adjusted incremental cost of £21 292 (95% CI £17 694 to £32 423, p<0.001).ConclusionsEvaluation of postoperative morbidity is more complicated than measuring early mortality. However, tracking morbidity after paediatric cardiac surgery over 6 months offers stakeholders important data that are of value to parents and will be useful in driving future quality improvement.

Medical rapid prototyping (MRP) in adult- and paediatric cardiac surgery

2011 ◽  
Vol 59 (S 01) ◽  
Author(s):  
R Sodian ◽  
S Haeberle ◽  
S Weber ◽  
T Lueth ◽  
A Beiras-Fernandez ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Rapid Prototyping ◽  
Paediatric Cardiac Surgery

scholarly journals Vocal cord palsy as a sequela of paediatric cardiac surgery – a review

2021 ◽  
pp. 1-9
Author(s):  
Aditi Sinha ◽  
Alexander Geragotellis ◽  
Guntaj Kaur Singh ◽  
Devika Verma ◽  
Daniyal Matin Ansari ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Vocal Cord ◽  
Vocal Fold ◽  
Heart Surgery ◽  
Vocal Cord Palsy ◽  
Standards Of Care ◽  
Management Options ◽  
Paediatric Cardiac Surgery ◽  
Cord Injury ◽  
Pda Ligation

Abstract Background: Vocal cord palsy is one of the recognised complications of complex cardiac surgery in the paediatric population. While there is an abundance of literature highlighting the presence of this complication, there is a scarcity of research focusing on the pathophysiology, presentation, diagnosis, and treatment options available for children affected by vocal cord palsy. Materials and methods: Electronic searches were conducted using the search terms: “Vocal Cord Palsy,” “VCP,” “Vocal Cord Injury,” “Paediatric Heart Surgery,” “Congenital Heart Surgery,” “Pediatric Heart Surgery,” “Vocal Fold Movement Impairment,” “VFMI,” “Vocal Fold Palsy,” “PDA Ligation.” The inclusion criteria were any articles discussing the outcomes of vocal cord palsy following paediatric cardiac surgery. Results: The two main populations affected by vocal cord palsy are children undergoing aortic arch surgery or those undergoing PDA ligation. There is paucity of prospective follow-up studies; it is therefore difficult to reliably assess the current approaches and the long-term implications of management options. Conclusion: Vocal cord palsy can be a devastating complication following cardiac surgery, which if left untreated, could potentially result in debilitation of quality of life and in severe circumstances could even lead to death. Currently, there is not enough high-quality evidence in the literature to aid recognition, diagnosis, and management leaving clinicians to extrapolate evidence from adult studies to make clinical judgements. Future research with a focus on the paediatric perspective is necessary in providing evidence for good standards of care.

scholarly journals Postoperative breakthrough pain in paediatric cardiac surgery not reduced by increased morphine concentrations

2021 ◽  
Author(s):  
Sjoerd de Hoogd ◽  
Sebastiaan C. Goulooze ◽  
Abraham J. Valkenburg ◽  
Elke H. J. Krekels ◽  
Monique van Dijk ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Breakthrough Pain ◽  
Paediatric Cardiac Surgery

Global leadership in paediatric and congenital cardiac care: “Humility in Leadership – an interview with Katarina Hanséus, MD, PhD, President of the Association for European Paediatric and Congenital Cardiology (AEPC)”

2021 ◽  
Vol 31 (5) ◽  
pp. 689-695
Author(s):  
Justin T. Tretter ◽  
Jeffrey P. Jacobs
Keyword(s):  
Cardiac Surgery ◽  
Global Leadership ◽  
University Hospital ◽  
Cardiac Care ◽  
Paediatric Surgery ◽  
Cross Sectional ◽  
Paediatric Cardiology ◽  
Pediatric Society ◽  
European Paediatric ◽  
Paediatric Cardiac Surgery

AbstractDr. Katarina Hanséus is the focus of our fourth in a series of interviews in Cardiology in the Young entitled, “Global Leadership in Paediatric and Congenital Cardiac Care”. Dr. Hanséus was born in Malmö, Sweden. She attended undergraduate school in her home town in Malmö, Sweden, graduating in 1974. Dr. Hanséus then went on to complete medical school at University of Lund in Lund, Sweden, graduating in 1980, where additionally she completed a Doctoral Dissertation in the evaluation of cardiac function and chamber size in children using Doppler and cross-sectional echocardiography. Under the Swedish Board of National Welfare, Dr. Hanséus completed her authorisation as a paediatrician in 1986, followed by her authorisation as a paediatric cardiologist in 1988, at University of Lund. She was appointed head of Paediatric Cardiology in 2000 at the Children’s Heart Center, Skane University Hospital, Lund, Sweden. The programme at Lund serves as one of the two national referral centres for comprehensive paediatric and congenital cardiac care, including paediatric cardiac surgery, in Sweden. From 2006 to 2013, she served as the clinical and administrative head of the Department of Neonatology, Paediatric Surgery, Paediatric Intensive Care, Paediatric Cardiology, and Paediatric Cardiac Surgery, returning as the head of Paediatric Cardiology in 2013, for which she currently holds the position.Dr. Hanséus is a recognised leader in the field of Paediatric Cardiology and has been involved in leadership within the Swedish Pediatric Society, the Swedish Association for Pediatric Cardiology, and the Association for European Paediatric and Congenital Cardiology throughout her career. Within the Association for European Paediatric and Congenital Cardiology, she served as the Secretary General from 2011 to 2016, the President Elect in 2018, and is the current President serving from 2019 until 2022. This article presents our interview with Dr. Hanséus, an interview that covers her experience as a leader in the field of Paediatric Cardiology, including the history and goals of the Association for European Paediatric and Congenital Cardiology, and her role and vision as their current President.

Sign in / Sign up

Export Citation Format

Share Document