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Paediatric cardiac surgery in a peripheral European region: is a joint programme a safe alternative to regionalisation?

Published online by Cambridge University Press:  18 April 2016

Gabriele M. Iacona ,
Alessandro Giamberti ,
Raul F. Abella ,
Giuseppe Pomè ,
Julio Agredo ,
Saúl G. Mendieta ,
Antonio Forcano ,
Concepción Sobrado ,
Josepha Suaréz  and
Sonia Peñate
...Show all authors
Gabriele M. Iacona*
Affiliation:
Yale University School of Medicine, Yale New Haven Hospital, New Haven, Connecticut, United States of America
Alessandro Giamberti
Affiliation:
Division of Cardiac Surgery, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy
Raul F. Abella
Affiliation:
Congenital Cardiac Surgery Service, Vall d’Hebron General Hospital, Barcelona, Spain
Giuseppe Pomè
Affiliation:
Division of Cardiac Surgery, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy
Julio Agredo
Affiliation:
Medical Surgical Unit of Paediatric Cardiology and Heart Abnormalities, Complejo Hospitalario Universitario Insular Materno Infantil, Las Palmas de Gran Canaria, Spain
Saúl G. Mendieta
Affiliation:
Medical Surgical Unit of Paediatric Cardiology and Heart Abnormalities, Complejo Hospitalario Universitario Insular Materno Infantil, Las Palmas de Gran Canaria, Spain
Antonio Forcano
Affiliation:
Medical Surgical Unit of Paediatric Cardiology and Heart Abnormalities, Complejo Hospitalario Universitario Insular Materno Infantil, Las Palmas de Gran Canaria, Spain
Concepción Sobrado
Affiliation:
Medical Surgical Unit of Paediatric Cardiology and Heart Abnormalities, Complejo Hospitalario Universitario Insular Materno Infantil, Las Palmas de Gran Canaria, Spain
Josepha Suaréz
Affiliation:
Medical Surgical Unit of Paediatric Cardiology and Heart Abnormalities, Complejo Hospitalario Universitario Insular Materno Infantil, Las Palmas de Gran Canaria, Spain
Sonia Peñate
Affiliation:
Medical Surgical Unit of Paediatric Cardiology and Heart Abnormalities, Complejo Hospitalario Universitario Insular Materno Infantil, Las Palmas de Gran Canaria, Spain
Asunción Melián
Affiliation:
Medical Surgical Unit of Paediatric Cardiology and Heart Abnormalities, Complejo Hospitalario Universitario Insular Materno Infantil, Las Palmas de Gran Canaria, Spain
Montserrat Volo
Affiliation:
Medical Surgical Unit of Paediatric Cardiology and Heart Abnormalities, Complejo Hospitalario Universitario Insular Materno Infantil, Las Palmas de Gran Canaria, Spain
Rafael González
Affiliation:
Medical Surgical Unit of Paediatric Cardiology and Heart Abnormalities, Complejo Hospitalario Universitario Insular Materno Infantil, Las Palmas de Gran Canaria, Spain
Marisa L. Antúnez
Affiliation:
Medical Surgical Unit of Paediatric Cardiology and Heart Abnormalities, Complejo Hospitalario Universitario Insular Materno Infantil, Las Palmas de Gran Canaria, Spain
Hipólito L. Falcón
Affiliation:
Medical Surgical Unit of Paediatric Cardiology and Heart Abnormalities, Complejo Hospitalario Universitario Insular Materno Infantil, Las Palmas de Gran Canaria, Spain
Francisco J. Cabrera
Affiliation:
Medical Surgical Unit of Paediatric Cardiology and Heart Abnormalities, Complejo Hospitalario Universitario Insular Materno Infantil, Las Palmas de Gran Canaria, Spain
Carlos Rubio
Affiliation:
Paediatric Cardiology, Hospital Universitario de Canarias, San Cristóbal de La Laguna, Santa Cruz de Tenerife, Spain
Javier Fernández
Affiliation:
Paediatric Cardiology, Hospital Universitario de Canarias, San Cristóbal de La Laguna, Santa Cruz de Tenerife, Spain
Pedro Suárez
Affiliation:
Medical Surgical Unit of Paediatric Cardiology and Heart Abnormalities, Complejo Hospitalario Universitario Insular Materno Infantil, Las Palmas de Gran Canaria, Spain
Cesar Perera
Affiliation:
Paediatric Cardiology, Hospital Universitario de Canarias, San Cristóbal de La Laguna, Santa Cruz de Tenerife, Spain
Alessandro Frigiola
Affiliation:
Division of Cardiac Surgery, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy
*
Correspondence to: G. M. Iacona, Yale University School of Medicine, Yale New Haven Hospital, 330 Cedar Street, Boardman 204, New Haven, CT 06520, United States of America. Tel: +12037857627; Fax: +12037853346; E-mail: [email protected]
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Abstract

Background

In 2007, a partnership was initiated between a small-volume paediatric cardiac surgery unit located in Las Palmas de Gran Canaria, Spain, and a large-volume cardiac surgery unit located in Milan, Italy. The main goal of this partnership was to provide surgical treatment to children with CHD in the Canary Islands.

Methods

An operative algorithm for performing surgery in elective, urgent, and emergency cases was adopted by the this joint programme. Demographic and in-hospital variables were collected from the medical records of all the patients who had undergone surgical intervention for CHD from January, 2009 to March, 2013. Data were introduced into the congenital database of the European Congenital Heart Surgeons Association Congenital Database and the database was interrogated.

Results

In total, 65 surgical mission trips were performed during the period of this study. The European Congenital Heart Surgeons Association Congenital Database documented 214 total patients with a mean age at operation of 36.45 months, 316 procedures in total with 198 cardiopulmonary bypass cases, 46 non-cardiopulmonary bypass cases, 26 cardiovascular cases without cardiopulmonary bypass, 22 miscellaneous other types of cases, 16 interventional cardiology cases, six thoracic cases, one non-cardiac, non-thoracic procedure on a cardiac patient with cardiac anaesthesia, and one extracorporeal membrane oxygenation case. The 30-day mortality was 6.07% (13 patients).

Conclusions

A joint programme between a small-volume centre and a large-volume centre may represent a valid and reproducible model for safe paediatric cardiac surgery in the context of a peripheral region.

Keywords

Paediatric cardiac surgeryregionalisation of careoutcomesAristotle score
Type
Original Articles
Information
Cardiology in the Young , Volume 27 , Issue 2 , March 2017 , pp. 273 - 283
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Copyright
© Cambridge University Press 2016 

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