-
[show abstract]
[hide abstract]
ABSTRACT: OBJECTIVES: We investigated whether open-heart surgery with the use of extracorporeal circulation has an impact on menstrual bleeding. METHODS: The menstrual bleeding pattern was registered in fertile women undergoing open-heart surgery in 2010-12. Haematocrit and 24-h postoperative bleeding were compared with those of men undergoing cardiac surgery. RESULTS: Women (n = 22), with mean age of 36 (range 17-60) years, were operated on and hospitalized for 4-5 postoperative days. The mean preoperative haematocrit was 40% (range 32-60%), and mean haematocrit at discharge was 32% (range 26-37%). Mean postoperative bleeding in the first 24 h was 312 (range 50-1442) ml. They underwent surgery for atrial septal defect (n = 5), composite graft/David procedure (n = 4), pulmonary or aortic valve replacement (n = 6), myxoma (n = 2), mitral valvuloplasty (n = 2), ascending aortic aneurysm (n = 1), aortic coarctation (n = 1) and total cavopulmonary connection (n = 1). Unplanned menstrual bleeding (lasting 2-5 days) was detected in 13 (60%) patients. Of them, 4 were 1-7 days early, 4 were 8-14 days early, 3 were 1-7 days late and 2 had menstruation despite having had menstrual bleeding within the last 2 weeks. None had unusually large or long-lasting menstrual bleeding. Ten women took oral contraceptives, 8 of whom had unexpected menstrual bleeding during admission. Men (n = 22), with a mean age of 35 (range 17-54) years, had mean bleeding of 331 (range 160-796) ml postoperatively, which was not statistically significantly different from the women's. The mean preoperative haematocrit was 40% (range 29-49%) among men, while haematocrit at discharge was 32% (28-41), not significantly different from that seen in the female subgroup. CONCLUSIONS: Menstrual bleeding patterns are disturbed by open-heart surgery in the majority of fertile women. Nevertheless, the unexpected menstrual bleeding is neither particularly long-lasting nor of large quantity, and the postoperative surgical bleeding is unaffected. We recommend that information about menstrual cycle disturbances related to cardiac surgery be provided, but no special precautions be taken, when operating on women of fertile age.
European journal of cardio-thoracic surgery: official journal of the European Association for Cardio-thoracic Surgery 04/2013; · 2.40 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Progressive cyanosis often develops following Kawashima operation in patients with left atrial isomerism, interrupted inferior vena cava and hepatic veins draining to the atria. Knowledge on the timing and extend of resolution following hepatic venous redirection is sparse. A girl developed progressing cyanosis following Kawashima operation at the age of ten months. Arterial oxygen saturations at rest dropped to 60-65%. Surgical redirection of hepatic veins into the cavopulmonary circulation at the age of three years had no immediate effect. However, arterial oxygen saturations increased gradually over nine months to 90-93% and 95-100% after three years.
Journal of Cardiothoracic Surgery 04/2013; 8(1):67. · 1.19 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Introduction. Transcatheter aortic valve implantation (TAVI) is established as an attractive treatment option for high-risk patients with aortic valve stenosis. One concern is the high risk of prosthetic valve regurgitation. This study aimed to examine for potential preoperative risk factors for postprocedural transcatheter heart valve regurgitation and to quantify the risk, degree, and consequences of postprocedural regurgitation. Materials and methods. 100 consecutive patients who underwent femoral (n = 22) or transapical (n = 78) TAVI were retrospectively reviewed. Echocardiographic valve regurgitation and clinical parameters were analyzed over the first year after TAVI. Results. Seventy-five percent of all patients had prosthetic valve regurgitation. It was, however, only mild or absent in 64% of patients and did not require re-intervention in any of the patients in the series. The severity of the regurgitation appeared unchanged over the one-year follow-up period. Moderate to severe regurgitation was associated with significant yet stable dilatation of the left ventricle over one year and lesser NYHA class improvement three months after TAVI. Asymmetrical native valve calcification increased the risk of paravalvular regurgitation non-significantly. Conclusion. Transcatheter heart valve regurgitation seems to be mild in the majority of cases and unchanged over a 12 months follow-up period. While affecting left ventricular dimensions in moderate or severe cases, we observed no obvious undesirable consequences of the prosthetic valve regurgitation within the first year.
Scandinavian cardiovascular journal: SCJ 09/2012; · 1.07 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: To investigate functional health status among adults previously operated for aortic coarctation (CoA) compared with healthy subjects; to assess the influence of medication and exercise capacity on patients' functional health.
Questionnaire-based investigation among 119 patients who underwent surgical repair of CoA during 1965-1985 and 36 age- and gender-matched healthy subjects using the SF-36 health survey. Original scores were transformed into norm-based scores, and summary scale scores were calculated. Exercise capacity was measured by symptom-limited bicycle ergometer testing.
Tertiary referral center.
Among 156 current survivors, 119 (74 males) participated in the study. Median age (range) at repair was 11 (0.1-40) years and 44 (26-72) years at follow-up.
Comparison of all components of SF-36 survey between patients and controls, as well as within patients regarding use of cardiovascular medication and exercise capacity.
Norm-based physical functioning scores were significantly lower among patients compared with controls (51.8 ± 7.1 vs. 54.3 ± 4.7, P < 0.05). Patients using antihypertensive medication scored significantly lower in all physical categories (physical component summary= 48.9 ± 10.4 vs. 54.9 ± 4.9, P < 0.05) as well as in vitality (46.4 ± 10.5 vs. 51.4 ± 10.4, P < 0.05). Patients with reduced exercise capacity scored significantly lower in several mental and physical categories compared with patients with normal exercise capacity (physical component summary= 49.7 ± 10.7 vs. 54.0 ± 6.2, P < 0.05; mental component summary= 44.9 ± 14.6 vs. 50.1 ± 10.0, P < 0.05).
Functional health status in patients late after CoA repair is only slightly impaired when compared with controls. However, the subgroup with reduced exercise capacity and need for cardiovascular medications have significant impairment on both physical and mental aspects of functional health.
Congenital Heart Disease 11/2011; 6(6):566-72. · 0.90 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: The objective of this study was to evaluate whether remote ischemic preconditioning can protect kidney function in children undergoing operation for complex congenital heart disease.
Children (n = 113) aged 0 to 15 years admitted for complex congenital heart disease were randomly allocated according to age to remote ischemic preconditioning and control groups. After exclusion of 8 patients, we conducted the analysis on 105 patients (remote ischemic preconditioning group, n = 54; control group, n = 51). Before surgery, remote ischemic preconditioning was performed as 4 cycles of 5 minutes of ischemia by inflating a cuff around a leg to 40 mm Hg above the systolic pressure. End points were development of acute kidney injury, initiation of dialysis, plasma creatinine, estimated glomerular filtration rate, plasma cystatin C, plasma and urinary neutrophil gelatinase-associated lipocalin, and urinary output. Secondary end points included postoperative blood pressure, inotropic score, and mortality, as well as morbidity reflected by reoperation and stays in the intensive care unit and hospital.
Overall, 57 of the children (54%) had acute kidney injury develop, with 27 (50%) in the remote ischemic preconditioning group and 30 (59%) in the control group (P > .2). Remote ischemic preconditioning was not associated with improvement in either any of the renal biomarkers or any of the secondary end points.
We found no evidence that remote ischemic preconditioning provided protection of kidney function in children undergoing operation for complex congenital heart disease.
The Journal of thoracic and cardiovascular surgery 09/2011; 143(3):576-83. · 3.41 Impact Factor
-
International journal of cardiology 09/2011; 156(1):e22-3. · 7.08 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: A 69-year-old man presented with symptoms of right heart failure due to stenosis of a tricuspid valve bioprosthesis. Echocardiography revealed right atrial dilatation and an estimated tricuspid valve area of 0.4 cm2. Because of advanced poor general condition and comorbidities, he was found unfit for conventional reoperation. Instead, transcatheter transatrial stent-valve implantation through a right thoracotomy was scheduled. The procedure resulted in a markedly improved clinical condition and an increased valve area measured to 2.5 cm2. In conclusion, transcatheter transatrial stent-valve implantation in stenotic valves is technically feasible and may lead to substantial improvement of the clinical condition.
The Annals of thoracic surgery 05/2011; 91(5):e74-6. · 3.74 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: The use of transcatheter aortic valve implantation (TAVI) for high-risk patients was introduced in the early 2000s for treatment of aortic valve stenosis patients with too high surgical risk. During the last years, there has been a dramatic increase in TAVI procedures. TAVI programs are implemented in numerous cardiac centers. This paper describes a single center experience with its first 100 TAVI procedures.
This study included the first 100 patients who were scheduled for either transfemoral (F-TAVI) or transapical (A-TAVI) aortic valve implantation at Aarhus University Hospital, Skejby, using the Edwards SAPIEN™ valve. The indication for TAVI was unacceptable high predicted risk associated with conventional surgery. Patients with adequate diameter of iliac arteries were scheduled for F-TAVI, otherwise A-TAVI was preferred.
The patients were treated between February 2006 and June 2010. Of these were 44% males and 56% females with a mean (S.D.) age of 81 (7.0). Thirty-days mortality rate was 8%, and decreased from 12% among the first 50 patients to 4% for the last 50 patients. Successful implantation was achieved in 92% patients. Major non-fatal complications were seen in 5% of 76 A-TAVI and in 0% of 24 F-TAVI patients. Mean (S.D.) EuroSCORE in the F-TAVI and A-TAVI groups was 15.9 (9.4) and 21.5 (14), respectively (p = 0.06). Post-procedural leakage of cardiac biomarkers was significantly higher in the A-TAVI group as compared to in the F-TAVI group. Mean (S.D.) NYHA class improved from 2.9 (0.6) to 1.8 (0.7) p < 0.001, with no significant difference between A-TAVI and F-TAVI patients.
In surgically non-amenable patients, TAVI can be performed with acceptable mortality and morbidity and results in marked functional improvement. A decrease in 30-day mortality over time indicated a learning curve when implementing this treatment.
Scandinavian cardiovascular journal: SCJ 04/2011; 45(5):261-6. · 1.07 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: The Risk Adjusted Classification for Congenital Heart Surgery can predict early mortality. However, the relation to long-term outcome in terms of mortality and morbidity is unknown.
We did a population-based follow-up study of 801 children undergoing congenital heart surgery between 1996 and 2002. All patients were followed from surgery until death or January 1, 2008. Operations were classified according to the Risk Adjusted Classification for Congenital Heart Surgery. Each patient was matched by age and sex with 10 population controls. Cox regression analysis, area under the receiver operator curve and competing risk analysis were used for the analyses.
Overall follow-up was 99.6%. The distribution of the Risk Adjusted Classification for Congenital Heart Surgery was: Category one 20%, category two 37%, category three 27%, category four 8%, category five 0% and category six 2%. Overall survival after a median follow-up of 8.2 years was 86% (95% confidence interval: 83-88%), with 54 early deaths occurring within 30 days after surgery and 57 late deaths. Long-term survival in those who were alive 30 days after surgery was 92% (90-94%); ranging from 98% (93-100%) in risk category one to 33% (5-68%) in category six. Survival overall and beyond 30 days was lower in each risk category than in controls (P < .001). During follow-up, 124 (15%) patients had new operations and 106 (13%) catheter-based interventions. These events were more frequent in category three, four, and six compared with category one, with no difference between category one and two. The area under the receiver operator curve for long-term mortality was 0.81 (95% confidence interval 0.75-0.87).
Children operated for congenital heart disease have impaired survival and often undergo new operations or catheter-based interventions. The risk of these events is related to the surgical complexity according to the Risk Adjusted Classification for Congenital Heart Surgery.
Congenital Heart Disease 03/2011; 6(4):322-9. · 0.90 Impact Factor
-
European Heart Journal 11/2010; 32(8):933. · 10.48 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: To examine long-term mortality in Danish patients with congenital heart defect (CHD), we performed a population-based follow-up study using nationwide registries. We identified all children born in Denmark from January 1, 1977 to January 1, 2006 from the Danish Civil Registration System. Children with a primary diagnosis of CHD, diagnosed before 1 year of age, were then identified in the National Registry of Patients. We computed cumulative mortality of patients and the background population according to birth period (1977 to 1986, 1987 to 1996, and 1997 to 2005). We identified 6,646 patients with CHDs. Overall cumulative mortality estimates in patients with CHDs at 1 year and 10 and 25 years of age were 20% (95% confidence interval [CI] 19 to 21), 25% (95% CI 24 to 26), and 28% (95% CI 27 to 30). In Danes born in the same period equivalent mortality estimates were 0.6% (95% CI 0.6 to 0.6), 0.8% (95% CI 0.7 to 0.8), and 1.3% (95% CI 1.3 to 1.3). Mortality differed substantially according to heart defect type and mortality at 10 years of age ranged from 9% (95% CI 6 to 12) in patients with atrial septal defects (n = 361) to 55% (95% CI 45 to 66) in patients with common arterial trunk (n = 78). Mortality decreased during the study period; 1-year mortality was 28% (95% CI 26 to 31) for patients born from 1977 to 1986 (n = 2,907) compared to 13% (95% CI 12 to 15) for patients born from 1997 to 2005 (n = 2,741). Mortality decreased in all heart defect type categories. In conclusion, mortality in patients with CHD was high compared to the general population, especially in infancy, but also after 10 years of age, emphasizing the need for long-term medical follow up. Mortality at 1 year of age has decreased substantially during recent decades.
The American journal of cardiology 11/2010; 106(9):1322-6. · 3.58 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: To examine if preoperative microalbuminuria is associated with an increased risk of long-term adverse outcomes following elective cardiac surgery and if it provides additional prognostic information beyond the European System for Cardiac Operative Risk Evaluation (EuroSCORE).
In a prospective follow-up study, we included 1049 patients undergoing elective cardiac surgery from 1 April 2005 to 30 September 2007. Microalbuminuria (urine albumin/creatinine ratio between 2.5 and 25 mg mmol(-1)) was assessed preoperatively in a morning spot-urine sample. We used population-based medical registries for follow-up from day 31 until day 365 postoperatively, and compared all-cause death, myocardial infarction, cerebral stroke and a composite outcome of severe infections including septicaemia, deep or superficial sternal wound infection, or leg wound infection among patients with or without microalbuminuria using Cox proportional hazard and competing risk regressions.
Microalbuminuria was found in 175 (18.5%) out of 947 patients available for follow-up. The adjusted risks of all-cause death (adjusted hazard ratio 2.3 (95% confidence interval 1.1-4.9)), stroke (adjusted hazard ratio 2.9 (95% confidence interval 1.1-7.8)) and severe infection composite outcome (adjusted hazard ratio 2.4 (95% confidence interval 1.2-4.9)) were doubled to tripled in patients with preoperative microalbuminuria. The risk of myocardial infarction was not increased. Adding information on microalbuminuria improved the predictive accuracy of the EuroSCORE regarding mortality (areas under receiver operating characteristic curves were: for the EuroSCORE 0.73 (95% confidence interval 0.65-0.81) and for EuroSCORE+microalbuminuria 0.76 (95% confidence interval 0.68-0.83).
Preoperative microalbuminuria is associated with an increased risk of long-term adverse outcomes in patients undergoing elective cardiac surgery, and it appears to provide prognostic information on mortality.
European journal of cardio-thoracic surgery: official journal of the European Association for Cardio-thoracic Surgery 11/2010; 39(6):932-8. · 2.40 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Blood flow distribution after ascending-to-descending aortic bypass in complex aortic arch obstruction is poorly described.
To study blood flow by magnetic resonance (MR) imaging at rest and during exercise in patients with aortic arch obstruction and a bypass tube and in healthy controls.
Seven patients (median 18 years (range: 14-54 years) and weight 79 kg (range 51-91 kg)) were studied 25 months (range 6-68 months) following surgical insertion of 14- or 16-mm bypass tube from the ascending to the distal descending thoracic aorta. Seven sex- and aged-matched normotensive subjects served as controls. MR real-time flow was measured in the ascending aorta and the proximal descending thoracic aorta in all participants and in the bypass tube in patients at rest and during supine leg exercise at 0.5 and 1.0 W kg(-1).
Ascending aortic flow at rest in patients was 2.9l min(-1)m(-2) (range 2.3-4.4) and increased with exercise to 5.3 (range 4.3-7.3) at 1.0 W kg(-1), which was not different from controls (3.4 (range 2.4-4.6) and 6.1 (range 5.0-6.9)). The bypass tube carried roughly the same flow as the proximal descending aorta at rest (1.5 (range 0.7-2.0) and 1.0 (range 0.2-2.0), respectively, and flows increased similarly during exercise (2.8 (range 1.5-4.0) and 2.0 (range 0.8-4.1), respectively at 1.0 W kg(-1)). Flow to the upper body did not differ between groups nor changed with supine leg exercise.
With aortic arch obstruction, an ascending-to-descending aortic bypass tube provides normal flow to the lower body at rest and during supine leg exercise without evidence of steal from the upper body.
European journal of cardio-thoracic surgery: official journal of the European Association for Cardio-thoracic Surgery 09/2009; 37(3):658-61. · 2.40 Impact Factor
-
Hans Henrik Møller Nielsen,
Henning Rud Andersen, Vibeke Elisabeth Hjortdal,
Kaj-Erik Klaaborg,
Carl-Johan Jakobsen,
Henrik Egeblad,
Kim Terp,
Christian Lindskov,
Erik Sloth,
Steen Hvidtfeldt Poulsen,
Ingeborg Bøing,
Leif Thuesen
[show abstract]
[hide abstract]
ABSTRACT: Recent years have seen the introduction of catheter-based aortic valve substitution with stent valves to treat aortic valve stenosis in patients who were deemed inoperable via conventional open heart surgery. We here report our initial experience.
Register-based study with prospective registration of prespecified parameters. A total of 26 patients were treated with an aortic stent valve, 12 via transfemoral (TFA-AVI) and 14 via transapical (TAP-AVI) access. In the TFA-AVI group, 75% were women and the average age was 85 4.5 years; in the TAP-AVI group, 71% were women and the average age was 79 8.4 years.
In the TFA-AVI group, successful stent valve implantation was performed in 9/12 (75%) and TAP-AVI in 13/14 (93%) patients. Mortality after 30 days was 25% in the TFA-AVI and 7% in the TAP-AVI group. The aortic valve area increased from 0.6 0.13 cm(2) to 1.6 0.39 (2) in the TFA-AVI group and from 0.7 0.2 (2) to 1.6 0.37 (2) in the TAP-AVI group. 91% of patients showed clinical improvement after treatment.
Transcatheter aortic valve implantation of conventional unresectable patients requires close cooperation between different specialities. The treatment seems to be a realistic alternative to medical treatment for inoperable patients and may even be used in operable high-risk patients.
Ugeskrift for laeger 09/2009; 171(33):2277-81.
-
[show abstract]
[hide abstract]
ABSTRACT: The risk of complications to acute myocardial infarction (AMI), such as cardiogenic shock, is 5-10%. The cause is often left heart failure and sometimes right heart failure, but it can be mechanical AMI complications (MCA) in the form of rupture of the left ventricle and papillary muscle rupture. This risk of MCA can be reduced by sufficient revascularisation, but these rare differential diagnoses to cardiogenic shock remain important. Echocardiography is the diagnostic gold standard. First line treatment is medical and often mechanical stabilization, but this should not delay quick surgical intervention.
Ugeskrift for laeger 07/2009; 171(23):1925-9.
-
[show abstract]
[hide abstract]
ABSTRACT: To examine if preoperative microalbuminuria (MA) is associated with in increased risk of adverse outcomes in patients undergoing elective cardiothoracic surgery, and if adding information on MA could improve the accuracy of the additive EuroSCORE.
In a follow-up study we included 962 patients undergoing elective cardiothoracic surgery from 1 April 2005 to 30 September 2007 at our department. MA (urine albumin/creatinine ratio between 2.5-25 mg/mmol) was assessed in a morning spot-urine sample. We used population-based medical registries for 30-day follow-up and compared the length of stay and adverse outcomes including (i) all-cause death, myocardial infarction, stroke, or atrial fibrillation, (ii) surgical reintervention, renal insufficiency, sternal wound infection, or septicaemia among patients with and without MA.
MA was found in 180 (18.7%) patients. The risk of both combined outcomes (adjusted odds ratios (ORs): 1.00 (95% confidence interval (CI): 0.77-1.30) and 1.18 (95% CI: 0.79-1.75), respectively) and most individual outcomes did not differ between the micro- and normoalbuminuric patients. The patients with MA and an additive EuroSCORE of 5 had a significantly prolonged median length of intensive care unit (ICU) stay (0.15 days [95% CI: 0.04-0.26]) and total hospital stay (0.5 days [95% CI: 0.04-0.96]). Patients with MA had a higher risk of postoperative septicaemia (OR: 12.1 [95% CI: 3.2-45.9]). Area under receiver operating characteristics curves of the EuroSCORE with regard to 30-day mortality was 0.86 both with and without MA.
Preoperative MA in patients undergoing elective cardiothoracic surgery was not associated with most early adverse outcomes. However, risk of septicaemia was higher and patients with MA also had a marginally longer length of ICU and hospital stay. Information on preoperative MA did not improve the accuracy of the additive EuroSCORE.
Interactive cardiovascular and thoracic surgery 07/2009; 9(3):484-90.
-
[show abstract]
[hide abstract]
ABSTRACT: An increasing number of grown-ups survive treatment for congenital heart disease due to improved prognostics for this group over the last decades. However, a smaller group of patients cannot be fully cured and encounter problems that require lifelong medical follow-up. This study examines how grown-ups with congenital heart disease (GUCH) understand their illness and body and describes the social and familial implications of the disease.
The study is based on participant observation in the GUCH patient organization, Hjerteungdom, and 11 semi-structured interviews with informants--all born with a severe congenital heart disease e.g. single ventricle, Steno Fallot, and transposition.
The informants try to compensate for the lack of physical performance by adapting to alternative rolls during physical activity and pursuing academic interests in order to obtain social recognition. The informants wish to define themselves as competent and normal young adults in public life in order to avoid being treated as ill. At the same time the informants need to discuss health concerns openly, which they have traditionally done with their parents as they know their entire medical history.
The informants experience limitations in their physical and social activities, but they try to adjust to living with a chronic disease and in this way they experience that the condition is controlled and mastered. GUCH patients can benefit from including personal and family issues in medical counselling because it can help them to cope with the disease in everyday life.
Ugeskrift for laeger 06/2007; 169(19):1797-800.
-
[show abstract]
[hide abstract]
ABSTRACT: Comparison of self-management of oral anticoagulant therapy versus conventional management has been hindered by use of different methods. We tested the hypothesis that there is no difference in the International Normalized Ratio (INR) variability, INR level, and coumarin dose among patients randomized to conventional management versus self-management.
The study design included uniform analysis of blinded control blood samples in both treatment arms. Ninety-two patients were randomly assigned to either self-management of oral anticoagulant therapy (including a teaching program for self-management followed by 6 months of independent self-management) or 6 months of conventional management. The endpoints were the variance (median square of the standard deviation) of the INR value, the median INR-value (using a blinded control sample analyzed monthly by a reference laboratory), and the coumarin dose.
Self-management was associated with a statistically significant smaller variance in INR values, a higher median INR value, and a higher dose of warfarin compared with conventional management. No difference was found in the group of patients using phenprocoumon.
Training and implementation of patient self-management leads to a smaller variance in INR values, a higher median INR value and a higher dose of coumarin compared with results obtained for conventionally managed patients.
American Journal of Cardiovascular Drugs 02/2007; 7(3):191-7. · 1.77 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: The efficacy of self-managed oral anticoagulant therapy has been addressed in few randomized controlled trials, which have provided inconsistent results. The aim of this study was to compare the quality of self-managed oral anticoagulant therapy with conventional management. One hundred patients were randomly assigned to the two treatment regimens, and it was found that the quality of self-management of oral anticoagulant therapy was at least as good as the treatment provided by conventional management. Self-management is therefore a valid management option in selected patients.
Ugeskrift for laeger 11/2006; 168(44):3817-20.
-
[show abstract]
[hide abstract]
ABSTRACT: Risk adjustment for specialties covering many diagnoses is difficult. The Risk Adjusted classification for Congenital Heart Surgery (RACHS-1) was created to compare the in-hospital mortality rate of groups of children undergoing surgery for congenital heart disease. We applied the classification to the operations performed at Skejby Sygehus (1996-2002) and found that RACHS-1 can be used to predict the in-hospital mortality rate and length of stay in the intensive care unit in a Danish center for congenital heart surgery. The mortality rate was similar to that reported by larger centers.
Ugeskrift for laeger 03/2006; 168(6):584-6.
