Abstract 14639: An Integrated Heart Center Model Improves Outcomes After Congenital Heart Surgery

• Published in: Circulation (New York, N.Y.) N.Y.), 2020-11, Vol.142 (Suppl_3 Suppl 3), p.A14639-A14639
• Main Authors: Mery, Carlos M, Well, Andrew M, Beckerman, Ziv, Gottlieb, Erin, Holt, Byron, Stromberg, Daniel, Krauklis, Kimberly, Morton, Laura, Denison, Blake, McCullum, Elizabeth, Fraser, Charles D
• Format: Article
• Language: English
• ISSN: 0009-7322; 1524-4539
• DOI: 10.1161/circ.142.suppl_3.14639

IntroductionContemporary experience suggests that congenital heart surgery (CHS) outcomes are optimized with an integrated, focused, and multidisciplinary program. In July 2018, our institution transitioned to an integrated Heart Center (IHC) model with new dedicated surgical, cardiac intensive care, anesthesiology, perfusion, and nursing teams. Multidisciplinary protocols and quality processes were implemented. This transition provides an unusual opportunity to evaluate the impact of an IHC model on outcomes after CHS. MethodsPatients who underwent index CHS 10/16-3/20 were included. The cohort was divided into 2 groupshistorical (first 21 mo) and IHC (second 21 mo). Cases were evaluated using STAT category, mortality, and other outcomes as defined by Society of Thoracic Surgeons criteria. Descriptive statistics, univariate analyses, and multivariable regression models were used. ResultsThe cohort included 627 patients (historical230, IHC396, 72% increase). Numbers of STAT 4 and 5 cases increased 174% (31 to 85) and 900% (1 to 10), respectively. Neonatal cases increased 100%, infants 138%, and adults 622%. Despite an increase in complexity, perioperative mortality decreased from 3.5% to 0.5% (p=0.007) (Table). Median postoperative length of stay (LOS) increased from 5[4-10] to 7 [4-18] days (p