New recommendations to improve outcomes at US congenital heart surgery centers

Reviewed by Megan Craig, M.Sc.Sep 29 2023

A set of recommendations to address the known variation in outcomes at US congenital heart surgery centers has been endorsed by 15 collaborating societies led by the Congenital Heart Surgeons' Society (CHSS). The guidelines will appear in "Recommendations for Centers Performing Pediatric Heart Surgery in the United States," to be co-published in the World Journal for Pediatric and Congenital Heart Surgery, Annals of Thoracic Surgery, and Journal of Thoracic and Cardiovascular Surgery.

In the last several years there have been multiple news stories regarding poor outcomes at different congenital heart centers. These reports have led to understandable concern and confusion on the part of patients and their families about whether their own institution is providing safe, quality care. Under the leadership of the Congenital Heart Surgeons' Society -; the leading professional society for congenital heart surgery -; our specialty, for the first time, has put forward recommendations for all congenital heart surgery centers. "

David M. Overman MD, CHSS President

The comprehensive guidelines describe structure, process, and outcome components necessary for essential and comprehensive care centers. Essential care centers provide services for any program, while comprehensive care centers offer services that optimize extensive and highly complex care.

The recommendations cover 14 strategic pediatric cardiac areas:

• Heart surgery program
• Heart center
• Hospital
• Acute care
• Anesthesia
• Cardiac intensive care unit (CICU)
• Catheterization
• Electrophysiology
• Heart failure
• Imaging
• Longitudinal follow up
• Perfusion
• Quality & safety
• Transplant

The guidelines have been endorsed by the Congenital Heart Surgeons' Society, Society of Thoracic Surgeons, American Association for Thoracic Surgery, American Academy of Pediatrics, American College of Cardiology, American Heart Association, American Society of Echocardiography, American Society of Extracorporeal Technology, Congenital Cardiac Anesthesia Society, Pediatric & Congenital Electrophysiology Society, Pediatric and Congenital Interventional Cardiovascular Society, Pediatric Cardiac Intensive Care Society, Pediatric Heart Transplant Society, Society of Pediatric Cardiovascular Nurses, and World Society for Pediatric and Congenital Heart Surgery.

It is anticipated that the recommendations will be of interest to the public, as well as elicit the attention of payers, government, hospital administration, and parent groups.

"These guidelines will allow patients and families to better understand what they should expect at their institution and will drive improvement of outcomes across all centers, " concluded Dr. Overman.