title: Clinical outcome of patients in a start-up congenital heart surgery program in Turkey.
abstract: This study summarizes the clinical outcome data of a start-up congenital heart surgery program in Turkey. Between December 2009 and February 2012, 616 operations have been performed in 132 newborns (22%), 260 infants (42%), and 224 children/adolescents (36%). Risk adjustment analysis was performed using the risk adjustment in congenital heart surgery (RACHS-1) risk assessment model. There were 66 mortalities (10.7%). According to the RACHS-1 categories, there were 51 cases in level I (8.2%) with no mortality (0%), 250 in level II (40.6%) with 11 (4.4%) mortalities, 199 in level III (32.3%) with 33 (16.5%) mortalities, 53 in level IV (8.6%) with 10 (18.8%) mortalities, 14 in level V and VI (2.2%) with 11 (78.5%) mortalities, and 49 cases (7.9%) out of the RACHS-1 categories with one (2.0%) mortality. Mortality was higher in neonates compared to infants, and in infants compared to children/adolescents. Mortality was higher in palliative procedures compared to corrective procedures. The data demonstrate that a start-up program with a relatively loaded surgical volume may achieve acceptable clinical results with a good teamwork. Collaboration of anesthesiologists, perfusionists, pediatric cardiologists, intensivists, and cardiovascular surgeons is necessary to provide a better outcome in congenital heart surgery.
authors.affiliation: Department of Cardiovascular Surgery, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Education and Training Hospital, Istanbul, Turkey.
authors.forename: Ismihan Selen
authors.initials: IS
authors.lastname: Onan
authors.forename: Ersin
authors.initials: E
authors.lastname: Erek
authors.forename: Sertac
authors.initials: S
authors.lastname: Haydin
authors.forename: Burak
authors.initials: B
authors.lastname: Onan
authors.forename: Ozgen Ilgaz
authors.initials: OI
authors.lastname: Kocyigit
authors.forename: Ufuk
authors.initials: U
authors.lastname: Topuz
authors.forename: Ender
authors.initials: E
authors.lastname: Odemis
authors.forename: Mehmet
authors.initials: M
authors.lastname: Yeniterzi
authors.forename: Ihsan
authors.initials: I
authors.lastname: Bakir
mesh_terms: D000293:Adolescent; D006348:Cardiac Surgical Procedures; D002648:Child; D002675:Child, Preschool; D005260:Female; D006330:Heart Defects, Congenital / Q000401:mortality / Q000601:surgery*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D010043:Outcome and Process Assessment, Health Care; D012189:Retrospective Studies; D020379:Risk Adjustment; D012307:Risk Factors; D014421:Turkey / Q000453:epidemiology