Our Summary

The Society of Thoracic Surgeons (STS) maintains a database on congenital heart surgeries. This database helps to predict the risk of death during these operations. However, the best method for doing this is still unclear. This study used two new mathematical models to predict the risk of death. The researchers found that these new models performed similarly to the current STS model. However, the new models were better at predicting death risk in high-risk surgeries. This is likely due to the inclusion of new variables related to certain diagnoses and procedures in the new models. The study concludes that it might be beneficial to compare these models further, particularly in the context of evaluating the quality of surgical programs.

FAQs

  1. What is the purpose of the database maintained by the Society of Thoracic Surgeons (STS)?
  2. How did the new mathematical models for predicting death risk during cardiac surgery perform compared to the existing STS model?
  3. What makes the new models better at predicting death risk in high-risk surgeries compared to the current STS model?

Doctor’s Tip

A helpful tip a doctor might tell a patient about cardiac surgery is to discuss the risk assessment and prediction models used for their specific surgery. Understanding the factors that contribute to the risk of complications or death can help the patient make informed decisions and better prepare for the procedure. It is important to ask questions and seek clarification from the medical team to ensure a thorough understanding of the potential outcomes and steps to take for a successful recovery.

Suitable For

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

  1. Coronary artery disease: Patients with blockages in their coronary arteries that restrict blood flow to the heart muscle may require bypass surgery or angioplasty with stenting.

  2. Valvular heart disease: Patients with damaged heart valves (such as aortic stenosis or mitral regurgitation) may need valve repair or replacement surgery.

  3. Congenital heart defects: Patients born with structural heart abnormalities may require surgery to repair the defect and improve heart function.

  4. Heart failure: Patients with severe heart failure that is not responding to medication or other treatments may be candidates for a heart transplant or ventricular assist device implantation.

  5. Aneurysms: Patients with weakened areas in the walls of their blood vessels, such as an aortic aneurysm, may require surgical repair to prevent rupture.

  6. Arrhythmias: Patients with abnormal heart rhythms that cannot be controlled with medication may need surgery, such as a maze procedure for atrial fibrillation.

Ultimately, the decision to undergo cardiac surgery is made on a case-by-case basis by a multidisciplinary team of healthcare providers, taking into consideration the patient’s overall health, the severity of their condition, and the potential risks and benefits of the procedure.

Timeline

Before cardiac surgery:

  • Patient is diagnosed with a heart condition that requires surgical intervention
  • Patient undergoes pre-operative testing and evaluations to assess their overall health and readiness for surgery
  • Patient receives education on the procedure, risks, and post-operative care
  • Surgery date is scheduled, and patient prepares for the procedure

After cardiac surgery:

  • Patient undergoes the surgical procedure, which may include bypass surgery, valve repair or replacement, or other interventions
  • Patient is monitored closely in the intensive care unit immediately after surgery
  • Patient gradually transitions to a regular hospital room as they recover
  • Physical therapy and other rehabilitation services may be provided to help the patient regain strength and mobility
  • Patient is discharged from the hospital and continues to follow up with their healthcare team for ongoing care and monitoring

What to Ask Your Doctor

  1. What specific type of cardiac surgery do I need, and why is it necessary?
  2. What are the risks and potential complications associated with this surgery?
  3. How experienced are you in performing this type of surgery, and what is your success rate?
  4. Will I need any additional tests or procedures before the surgery?
  5. What is the expected recovery time and rehabilitation process after the surgery?
  6. Are there any alternative treatments or less invasive procedures that could be considered?
  7. What will be the long-term effects of this surgery on my heart health?
  8. How often will I need follow-up appointments after the surgery?
  9. What lifestyle changes or medications will I need to take after the surgery?
  10. Are there any support groups or resources available to help me prepare for and recover from the surgery?

Reference

Authors: Normand ST, Zelevinsky K, Nathan M, Abing HK, Dearani JA, Galantowicz M, Gaynor JW, Habib RH, Hanley FL, Jacobs JP, Kumar SR, McDonald DE, Pasquali SK, Shahian DM, Tweddell JS, Vener DF, Mayer JE Jr. Journal: Ann Thorac Surg. 2022 Sep;114(3):785-798. doi: 10.1016/j.athoracsur.2021.11.077. Epub 2022 Feb 3. PMID: 35122722