Author + information
- Meena Nathana,b,
- Steven Colana,b,
- Jane Newburgera,b,
- Hua Liua,b,
- Kimberlee Gauvreaua,b,
- Brielle Tishlera,b and
- Pedro del Nidoa,b
Background: Technical Performance Score (TPS), an echocardiographic/clinical based tool that measures residua after congenital cardiac surgery, has been associated with in hospital and midterm outcomes. We sought to validate the ability of TPS to predict long-term outcomes.
Methods: We followed consecutive patients from 06/2005 to 06/2006 who had congenital heart surgery on cardiopulmonary bypass and survived to discharge for 10 years. TPS was assigned as Class 1 (no residua), Class 2 (minor residua), Class 3 (major residua or predischarge reintervention for major residua). Transplant-free survival and post discharge reinterventions were analyzed using Cox regression.
Results: Of 676 subjects, 357 (53%) were male, and median age at surgery 1.1 (IQR 0.2, 5.7) years. There were 163 (24%) post discharge reinterventions and 41 (6.1%) deaths/transplants. On multivariable modeling, Class 2 (HR 1.6, CI 1.1, 2.3; p=0.02), and Class 3 TPS (HR 2.8, CI 1.8, 4,4; p<0.001) had shorter time to reintervention. Class 3 TPS also had a greater hazard of death/transplant (HR 4.2, CI 1.9, 8.9; p<0.001). Transplant-free survival and freedom from reintervention are represented in figure.
Conclusions: Ten years after congenital heart surgery, presence of minor or major residua is associated with post discharge reintervention; and presence of major residua with mortality. The TPS enables identification of patients at risk for reintervention or death, allowing closer monitoring and timely intervention to improve outcomes.
Poster Hall, Hall C
Friday, March 17, 2017, 10:00 a.m.-10:45 a.m.
Session Title: Congenital Heart Disease: Progress in Pediatric Heart Surgery
Abstract Category: 10. Congenital Heart Disease: Pediatric
Presentation Number: 1101-014
- 2017 American College of Cardiology Foundation