Our Summary

The Society of Thoracic Surgeons (STS) Adult Cardiac Surgery Database is a massive and thorough resource used for understanding heart surgery. It currently has information on over 9 million procedures from over a thousand participants and more than 3,500 active surgeons. This database is used to create risk models, measure performance, make health policy decisions, and conduct research to improve patient care.

This report gives an update on the database and discusses the development of new risk models and an online risk calculator. It also offers insights into current practices in heart surgery. This includes changes in the patient profiles for aortic valve replacement, the use of less invasive techniques for valve and bypass surgery, and the use of surgical ablation and left atrial appendage ligation in patients with atrial fibrillation (an irregular heartbeat). The report also provides an overview of research conducted using the database and discusses future plans for it.

FAQs

  1. What is the purpose of the STS Adult Cardiac Surgery Database?
  2. How is the data from the STS Adult Cardiac Surgery Database used to improve patient care?
  3. What are some of the changes in heart surgery practices discussed in the report?

Doctor’s Tip

One helpful tip a doctor might tell a patient about cardiac surgery is to ask about the surgeon’s experience and success rates with the specific procedure being recommended. It is important to choose a surgeon who has a high level of expertise in performing the particular surgery you need, as this can greatly impact the outcome and reduce the risk of complications. Additionally, discussing any concerns or questions you may have with your surgeon before the procedure can help ensure that you are well-informed and prepared for the surgery.

Suitable For

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

  1. Coronary artery disease: Patients with blockages in the arteries that supply blood to the heart muscle may be recommended for coronary artery bypass grafting (CABG) surgery.

  2. Valvular heart disease: Patients with heart valve problems such as aortic stenosis, mitral regurgitation, or mitral valve prolapse may be recommended for valve repair or replacement surgery.

  3. Aortic aneurysm: Patients with an enlarged or weakened aorta may be recommended for surgery to repair or replace the damaged portion of the aorta.

  4. Arrhythmias: Patients with irregular heart rhythms such as atrial fibrillation may be recommended for surgery to correct the rhythm disturbance.

  5. Congenital heart defects: Patients born with structural abnormalities in the heart may be recommended for surgery to repair the defect.

  6. Heart failure: Patients with advanced heart failure that does not respond to medication or other treatments may be recommended for heart transplant surgery or left ventricular assist device (LVAD) implantation.

Overall, patients who are recommended for cardiac surgery are those who have a high risk of complications or death if left untreated, and for whom surgery offers the best chance of improving their quality of life and overall prognosis. The decision to recommend surgery is made on a case-by-case basis by a multidisciplinary team of healthcare providers, including cardiologists, cardiac surgeons, and other specialists.

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 suitability for surgery.
  3. Patient may receive counseling and education about the procedure and what to expect during recovery.
  4. Surgery is scheduled and the patient prepares by following instructions from their healthcare team, such as fasting before the procedure.

During Cardiac Surgery:

  1. Patient is brought into the operating room and given anesthesia to put them to sleep.
  2. Surgeons perform the necessary procedures, such as bypass surgery, valve replacement, or repair of heart defects.
  3. The surgery can last several hours, depending on the complexity of the procedure.
  4. Patient is closely monitored by medical staff throughout the surgery to ensure their safety.

After Cardiac Surgery:

  1. Patient is taken to the recovery room and closely monitored as they wake up from anesthesia.
  2. Patient may spend several days in the hospital for post-operative care and monitoring.
  3. Rehabilitation and physical therapy may be recommended to help the patient recover and regain strength.
  4. Follow-up appointments with the healthcare team are scheduled to monitor the patient’s progress and address any concerns.
  5. Patient may need to make lifestyle changes, such as diet and exercise, to improve their heart health and prevent future complications.

What to Ask Your Doctor

Some questions a patient should ask their doctor about cardiac surgery include:

  1. What specific procedure are you recommending for my condition?
  2. What are the potential risks and complications associated with this surgery?
  3. What is the expected outcome and recovery time for this surgery?
  4. How many times have you performed this type of surgery and what is your success rate?
  5. Will I need any additional tests or evaluations before the surgery?
  6. What are the alternatives to surgery and why do you recommend this particular procedure for me?
  7. What is the long-term outlook for my condition after surgery?
  8. Will I need any ongoing medications or lifestyle changes after the surgery?
  9. How should I prepare for the surgery in terms of diet, exercise, and medication?
  10. What support services are available to me during the recovery process?

Reference

Authors: Wyler von Ballmoos MC, Kaneko T, Iribarne A, Kim KM, Arghami A, Fiedler A, Habib R, Parsons N, Elhalabi Z, Krohn C, Bowdish ME. Journal: Ann Thorac Surg. 2024 Feb;117(2):260-270. doi: 10.1016/j.athoracsur.2023.11.016. Epub 2023 Nov 29. PMID: 38040323