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Editor
Courtney A. Hardy, MD
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Co-Editors
Mark Twite, MD, BCh
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Stuart R. Hall, MD
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Call for CCAS Directors Nominations
Preview of the CCAS
Program at Pediatric Anesthesiology 2010
An Interesting Case
The Anesthetic and Cardiopulmonary Bypass Management of an 800g Premature Neonate for the Arterial Switch Operation
PRO vs. CON
Should NIRS Monitoring Be Considered Standard of Care on Every Case Involving CPB?
Literature Reviews
1. Perioperative stroke in infants undergoing open heart operations for congenital heart disease.
2.
Brain maturation is delayed in infants with complex congenital heart defects.
CCAS STS Database Update
By David F. Vener, MD
Database Committee
Chair
It’s “Go Live” time (hopefully) in the database world for Congenital Heart Disease. Effective, January 1, 2010, the Society of Thoracic Surgery has rolled out its most recent version of the Congenital Heart Surgery database. Importantly for us, this update, which occurs every three years, includes our anesthesia data fields for the first time and represents a big step forward for our specialty and for the treatment of children and adults with CHD. We are very excited about the database because in addition to adding the anesthesia fields, the new version also adds some items that have never been used before. A few highlights include the following:
- Using a combination of protected data (names, social security numbers, etc.), patients will be assigned a Unique Patient Identifier that will allow them to be tracked longitudinally as they age and cross multiple institutions. For example, a child having a Norwood procedure in one location and a subsequent Glenn procedure in a second hospital 4 months later and a Fontan 2 or 3 years later at a third facility will be able to be identified for long-term follow-up using the data. This UPI algorithm can be applied to multiple specialty databases such as IMPACT (Interventional Cardiology) or VPICU (Intensive Care) to build a comprehensive care picture of a given patient, regardless of institution location(s).
- The STS, the CCAS and the various other specialty organizations have coordinated their definitions of diagnosis, procedures and complications so that there is a consistent language between all, including the European and Asian societies developing the same systems.
- New codes consistent with what other specialty societies are using have been incorporated into the STS diagnosis and procedure options.
- Anesthesia can serve as a common ground for many of these different specialties since we cross over into areas not previously covered by the STS, including interventional and diagnostic cardiology and radiology as well as the general operating rooms where our patients have non-cardiac procedures under our care and the ICU.
In order for an anesthesia program to participate, their surgical colleagues must be participating members in the STS (which almost all are now) and the anesthesiologists must sign participation agreements with the STS and the Duke Clinical Research Institute to establish a “business” relationship for the purpose of HIPAA compliance. The current fee for database participation is $3500 per year per program for anesthesia, in addition to the surgical participation fee. This fee will allow programs to enter an unlimited number of patient encounters and to have their data be included in the national data that is used to generate the annual outcomes reports. Participating programs will also have access to the de-identified data for research and publication purposes. While this first year or two will probably start out with only a limited amount of programs participating, it is hoped that we will eventually be able to include many of the anesthesia departments who contribute surgical data.
The database committee wishes to thank the following institutions whose financial support has underwritten this project for the last 3 years: Children’s Hospital of Philadelphia, Cleveland Clinic, Texas Children’s Hospital, Children’s Healthcare of Atlanta/Sibley Heart Center, University of Virginia, Columbia University/Morgan Stanley Children’s Hospital, St. Joseph’s Children’s Hospital of Tampa, Miami Children’s Hospital, Children’s Hospital Denver and Children’s Hospital Los Angeles.
David F. Vener, MD (chair)
David Jobes, MD
Courtney Hardy, MD
Frank McGowan, MD
Scott Schulman, MD
Anshuman Sharma, MD
Lena Sun, MD
Mark Twite, MD
Glyn Williams, MD
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