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Multicenter Study
. 2020 Jul;160(1):218-223.e1.
doi: 10.1016/j.jtcvs.2019.10.146. Epub 2019 Nov 15.

The Pediatric Heart Network Residual Lesion Score Study: Design and objectives

Meena Nathan  1 , Felicia L Trachtenberg  2 , Maria I Van Rompay  2 , William Gaynor  3 , Kirk Kanter  4 , Richard Ohye  5 , Emile A Bacha  6 , James Tweddell  7 , Steven M Schwartz  8 , L LuAnn Minich  9 , Carlos M Mery  10 , Steven D Colan  11 , Jami Levine  11 , Linda M Lambert  9 , Jane W Newburger  11 ; Pediatric Heart Network Residual Lesion Score Writing Committee
Collaborators, Affiliations
Multicenter Study

The Pediatric Heart Network Residual Lesion Score Study: Design and objectives

Meena Nathan et al. J Thorac Cardiovasc Surg. 2020 Jul.

Abstract

Objectives: The Residual Lesion Score (RLS) was developed as a novel tool for assessing residual lesions after congenital heart operations based on widely available clinical and echocardiographic characteristics. The RLS ranks postoperative findings as follows: Class 1 (no/trivial residua), Class 2 (minor residua), or Class 3 (major residua or reintervention before discharge for residua). The multicenter prospective RLS study aims to analyze the influence of residual lesions on outcomes in common congenital cardiac operations. We hypothesize that RLS will predict postoperative adverse events, resource utilization, mortality, and reinterventions by 1 year postoperatively.

Methods: The study cohort consisted of infants aged ≤12 months undergoing definitive surgery for complete atrioventricular septal defect, tetralogy of Fallot, dextro-transposition of the great arteries with or without intact ventricular septum, single ventricle (Norwood procedure), and coarctation or interrupted/hypoplastic arch with ventricular septal defect. Children with major congenital or acquired extracardiac anomalies that could independently affect the primary end point, which was number of days alive and out of the hospital within 30 days of surgery (60 days for Norwood procedure), were excluded. Secondary outcomes included ≥1 early major postoperative adverse event; days of intensive care unit and hospital stay, and initial and total ventilator time; mortality/transplant after discharge; unplanned reinterventions after discharge; and cost. All analyses will be performed separately by surgical operation.

Conclusions: This is the first multicenter prospective validation of a tool for surgical outcome assessment and quality improvement specific to congenital heart surgery.

Keywords: congenital heart surgery, Residual Lesion Score, outcomes.

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Conflict of interest statement

Disclosures/ Conflicts of Interest:

Maria Van Rompay: HealthCare/New England Research Institute grant support

William Gaynor: NIH grant support as above

Luanne Minich: NHLBI and PHN grant support as above

Carlos Mery: NHLBI grants as above

Jami Levine: NHLBI grants as above

Linda Lambert: NHLBI grants as above

Carolyn Dunbar-Masterson: NHLBI/PHN grant support as above

Geetha Raghuveer: NHLBI/PHN grant support as above

Jeffrey P. Jacobs : NHLBI grant as above

Jane Newburger: NHLBI grant support as above

Figures

Central picture:
Central picture:
Residual Lesion Score
Figure 1:
Figure 1:. Residual Lesion Score Study Outline
(ASO: arterial switch operation; CAVSD: complete atrioventricular septal defect; PHN: Pediatric Heart Network; RLS: residual lesion score; TOF: tetralogy of Fallot; VSD: ventricular septal defect)
See this image and copyright information in PMC

Comment in

References

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