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Cardiac complications associated with the treatment of patients with congenital cardiac disease: consensus definitions from the Multi-Societal Database Committee for Pediatric and Congenital Heart Disease

Part of: The International Society for Nomenclature of Paediatric and Congenital Heart Disease (ISNPCHD)

Published online by Cambridge University Press:  01 December 2008

Emile Antoine Bacha ,
David Cooper ,
Ravi Thiagarajan ,
Rodney C.G. Franklin ,
Otto Krogmann ,
Barbara Deal ,
Constantine Mavroudis ,
Avinash Shukla ,
Thomas Yeh Jr  and
Paul Barach
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Emile Antoine Bacha*
Affiliation:
Department of Cardiac Surgery, Children’s Hospital Boston and Harvard Medical School, Boston, Massachusetts, United States of America;
David Cooper
Affiliation:
The Congenital Heart Institute of Florida (CHIF), Division of Critical Care, All Children’s Hospital andChildren’s Hospital of Tampa, University of South Florida College of Medicine, Florida Pediatric Associates, Saint Petersburg and Tampa, Florida, United States of America;
Ravi Thiagarajan
Affiliation:
Department of Cardiac Intensive Care, Children’s Hospital Boston and Harvard Medical School, Boston, Massachusetts, United States of America;
Rodney C.G. Franklin
Affiliation:
Paediatric Cardiology Directorate, Royal Brompton & Harefield NHS Trust, Harefield, Middlesex, United Kingdom;
Otto Krogmann
Affiliation:
Paediatric Cardiology – CHD, Heart Center Duisburg, Duisburg, Germany;
Barbara Deal
Affiliation:
Division of Cardiology, Children’s Memorial Hospital, and the Departments of Pediatrics and Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States of America
Constantine Mavroudis
Affiliation:
Division of Cardiovascular-Thoracic Surgery, Children’s Memorial Hospital, and the Departments of Pediatrics and Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States of America
Avinash Shukla
Affiliation:
Department of Cardiac Anesthesia, Children’s Hospital Boston and Harvard Medical School, Boston, Massachusetts, United States of America;
Thomas Yeh Jr
Affiliation:
Division of Cardiothoracic Surgery, Tulane University, New Orleans, Louisiana, United States of America;
Paul Barach
Affiliation:
Department of Anesthesia, University of Utrecht, Utrecht, Netherlands;
David Wessel
Affiliation:
Critical Care Medicine, Children’s National Medical Center, Washington DC, United States of America;
Giovanni Stellin
Affiliation:
Pediatric Cardiac Surgery Unit, University of Padova Medical School, Padova, Italy;
Steven D. Colan
Affiliation:
Department of Cardiology, Children’s Hospital Boston and Harvard Medical School, Boston, Massachusetts, United States of America
*
Correspondence to: Emile A. Bacha, MD, Associate Professor of Surgery, Harvard Medical School, Senior Associate in Cardiac Surgery, Children’s Hospital Boston, 300 Longwood Ave. Bader 273, Boston, MA 02115, United States of America. Tel: 001-617 355 5637; Fax: 001-617 730 0214; E-mail: [email protected]
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Abstract

A complication is an event or occurrence that is associated with a disease or a healthcare intervention, is a departure from the desired course of events, and may cause, or be associated with, suboptimal outcome. A complication does not necessarily represent a breech in the standard of care that constitutes medical negligence or medical malpractice. An operative or procedural complication is any complication, regardless of cause, occurring (1) within 30 days after surgery or intervention in or out of the hospital, or (2) after 30 days during the same hospitalization subsequent to the operation or intervention. Operative and procedural complications include both intraoperative/intraprocedural complications and postoperative/postprocedural complications in this time interval.

The MultiSocietal Database Committee for Pediatric and Congenital Heart Disease has set forth a comprehensive list of complications associated with the treatment of patients with congenital cardiac disease, related to cardiac, pulmonary, renal, haematological, infectious, neurological, gastrointestinal, and endocrinal systems, as well as those related to the management of anaesthesia and perfusion, and the transplantation of thoracic organs. The objective of this manuscript is to examine the definitions of operative morbidity as they relate specifically to the cardiac system. These specific definitions and terms will be used to track morbidity associated with surgical and transcatheter interventions and other forms of therapy in a common language across many separate databases.

The MultiSocietal Database Committee for Pediatric and Congenital Heart Disease has prepared and defined a near-exhaustive list of cardiac complications, including intraoperative complications and cardiopulmonary bypass-related complications. These cardiac complications are presented in the following subgroups:

1) Cardiac (general)

2) Cardiac – Metabolic

3) Cardiac – Residual and Recurrent cardiac lesions

4) Arrhythmia

5) Cardiopulmonary bypass and Mechanical circulatory support, and

6) Operative/Procedural.

Within each subgroup, complications are presented in alphabetical order. Clinicians caring for patients with congenital cardiac disease will be able to use this list for databases, quality improvement initiatives, reporting of complications, and comparing strategies for treatment.

Keywords

Congenital heart diseasequality improvementpatient safetyoutcomesregistryoperative morbiditypaediatricsurgerycongenital abnormalitiescardiac surgical proceduresheart
Type
Original Article
Information
Cardiology in the Young , Volume 18 , Issue S2: Databases and the assessment of complications associated with the treatment of patients with congenital cardiac disease , December 2008 , pp. 196 - 201
Copyright
Copyright © Cambridge University Press 2008

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