Our Summary

This research paper discusses the Society of Thoracic Surgeons (STS) Adult Cardiac Surgery Database (ACSD), which is the most comprehensive cardiac surgery database. This database, containing over 8.3 million procedures from over 1000 institutions, covers more than 97% of all heart surgeries in the US. It is a key tool for improving the quality of care, ensuring patient safety, and reporting on surgery outcomes. The database has recently added new risk models for various types of heart valve surgeries. It can also now provide data on long-term survival rates by linking to the National Death Index. The paper reviews current trends in the database until the end of 2023, significant research over the past year, and new features being added to the database.

FAQs

  1. What is the Society of Thoracic Surgeons Adult Cardiac Surgery Database (ACSD)?
  2. How does the ACSD help in improving the quality of care and patient safety?
  3. What are the new features recently added to the ACSD?

Doctor’s Tip

A helpful tip a doctor might tell a patient about cardiac surgery is to follow post-operative care instructions closely, including taking prescribed medications, attending follow-up appointments, and participating in cardiac rehabilitation programs. It is important to listen to your body, report any unusual symptoms to your healthcare provider, and make necessary lifestyle changes to support your recovery and overall heart health. Compliance with medical advice and lifestyle modifications can greatly improve outcomes and reduce the risk of complications after cardiac surgery.

Suitable For

Patients who are typically recommended for cardiac surgery include those with:

  1. Coronary artery disease: Patients with severe blockages in the coronary arteries that cannot be managed with medications or interventions such as angioplasty may be recommended for coronary artery bypass grafting (CABG) surgery.

  2. Valvular heart disease: Patients with severe narrowing (stenosis) or leakage (regurgitation) of the heart valves may require valve repair or replacement surgery.

  3. Congenital heart defects: Patients born with structural abnormalities in the heart may require surgical correction to improve heart function and prevent complications.

  4. Aortic aneurysms: Patients with aortic aneurysms (weakened and bulging areas in the aorta) may require surgery to repair the aneurysm and prevent rupture.

  5. Heart failure: Patients with end-stage heart failure that cannot be managed with medications or other interventions may be candidates for heart transplant surgery or ventricular assist device (VAD) implantation.

  6. Arrhythmias: Patients with abnormal heart rhythms that do not respond to medications or other treatments may require surgical procedures such as maze surgery or ablation therapy.

  7. Other complex heart conditions: Patients with other complex heart conditions that cannot be managed with medications or interventions may require surgical treatment to improve heart function and quality of life.

Overall, the decision to recommend cardiac surgery is made on a case-by-case basis after careful evaluation of the patient’s medical history, symptoms, and overall health status. The goal of cardiac surgery is to improve heart function, relieve symptoms, and reduce the risk of complications associated with heart disease.

Timeline

Before cardiac surgery:

  1. Patient is diagnosed with a heart condition that requires surgical intervention.
  2. Patient undergoes pre-operative testing and evaluation to assess their overall health and readiness for surgery.
  3. Patient meets with their cardiac surgeon to discuss the procedure, risks, and expected outcomes.
  4. Patient may need to make lifestyle changes, such as quitting smoking or adjusting medications, to optimize their health before surgery.

After cardiac surgery:

  1. Patient is closely monitored in the intensive care unit immediately after surgery to ensure stability and recovery.
  2. Patient may stay in the hospital for several days to a week, depending on the complexity of the surgery and their individual recovery progress.
  3. Patient undergoes physical therapy and rehabilitation to regain strength and mobility.
  4. Patient follows up with their cardiac surgeon for post-operative appointments to monitor healing and address any concerns.
  5. Patient may need to make further lifestyle changes, such as starting a cardiac rehabilitation program or modifying their diet and exercise habits, to support long-term heart health.

What to Ask Your Doctor

  1. What specific type of cardiac surgery do I need and why?
  2. What are the risks and potential complications associated with this surgery?
  3. How experienced is the surgical team in performing this type of surgery?
  4. What is the expected outcome of the surgery and what is the success rate?
  5. What is the recovery process like and how long will it take?
  6. Are there any alternative treatment options to consider?
  7. What is the long-term prognosis after this surgery?
  8. Will I need any follow-up care or additional treatments post-surgery?
  9. What lifestyle changes or modifications will I need to make after the surgery?
  10. Are there any specific pre-operative preparations I should be aware of?

Reference

Authors: Iribarne A, Zwischenberger B, Hunter Mehaffey J, Kaneko T, Wyler von Ballmoos MC, Jacobs JP, Krohn C, Habib RH, Parsons N, Badhwar V, Bowdish ME. Journal: Ann Thorac Surg. 2025 Jun;119(6):1139-1150. doi: 10.1016/j.athoracsur.2025.03.011. Epub 2025 Mar 22. PMID: 40127833