Neonatal Cardiac Surgery Age < 30 Days
Early repair of congenital heart defects in neonates can minimize the need for future surgeries. For decades, our comprehensive Neonatal Cardiac Surgery program has been performing neonatal repairs of congenital defects – such as transposition of the great arteries, coarctation of the aorta, truncus arteriosus, and hypoplastic left heart syndrome – with outstanding results. Columbia-Presbyterian surgeons James R. Malm and Frederick O. Bowman Jr. pioneered many of the early cardiac repair techniques used today, including Tetralogy of Fallot repair and the use of the heart-lung machine in children.
Volume: 200 Annual Admissions
The Tri-State area’s largest referral center for babies born with congenital heart disease, we admit approximately 200 babies every year. Not all of these infants require surgery.
Complexity-Adjusted Performance Measurement
Mortality is the most common performance metric used in the following outcomes of congenital heart surgery. However, many variables can affect patient care outcomes.
To compare the performance of congenital heart surgery centers, the Society of Thoracic Surgeons (STS) assigned scores for each surgical procedure based on the potential for mortality, the potential for morbidity, and surgical difficulty – from a risk of 1 to 5, with five the most difficult.
Our mortality rate for neonates is among the lowest in the nation 7.4%
NewYork-Presbyterian 2013 -2016
The most recent STS report cites an overall neonatal mortality of 7.4% for NewYork-Presbyterian. STS predicted mortality was 8.1% based on the complexity of our cases.
| Performance Excellence | NewYork-Presbyterian Mortality | STS Benchmark Mortality |
|
Overall |
7.4% |
8.6% |
|
Difficulty 1 |
0% |
1.7% |
|
Difficulty 2 |
5.7% |
3.4% |
|
Difficulty 3 |
3.1% |
3.2% |
|
Difficulty 4 |
8.5% |
8.8% |
|
Difficulty 5 |
11.9% |
17.0% |
Norwood Procedure
Infants with Hypoplastic Left Heart Syndrome (HLHS) have an incompletely formed left ventricle. Since the early 1980s, a three-step serial procedure designed to create normal blood flow in and out of the heart has extended the life of infants born with HLHS. The Norwood procedure, the first of the three procedures, has the highest risk-adjusted mortality rate among all neonatal and pediatric heart surgeries.
We have decades of experience with the Norwood procedure and stage palliation for HLHS, having performed it since 1985. Our outcomes for this type of repair rank among the best in the country. We are currently involved in a major multi-institutional study evaluating this and other innovative procedures for the treatment of HLHS.
Survival following the Norwood procedure continues to be a challenge. On average, about 80 percent survive. Hospital mortality after the Norwood procedure is more than 14 percent in the Society of Thoracic Surgeons (STS) database for 2013-2016.
The Congenital Heart Center mortality rate following the Norwood Procedure has declined substantially since 2005, with survival now more than 90 percent. Notably, there was no mortality in 2014 for infants undergoing the first stage operation.
Our survival rate after the Norwood Procedure is among the best in the country 90.9%
NewYork-Presbyterian 2013 -2016
Total Norwood Procedure Volume = 67 2013-2016 |
NewYork-Presbyterian | STS National Benchmark |
| Overall Hospital Discharge Mortality Rate | 9.1% | 14.7% |
Arterial Switch Operation (ASO)
The arterial switch operation corrects transposition of the great arteries, a condition in which anatomical positions of the pulmonary artery and the aorta are switched so that the aorta rises from the right ventricle and the pulmonary artery arises from the left ventricle. This anomaly causes oxygen-poor blood, a life-threatening medical emergency requiring immediate treatment.
In the 1980s and 1990s, NewYork-Presbyterian’s Dr. Jan Quaegebeur, one of the nation’s top pediatric heart surgeons, pioneered this innovative procedure which re-establishes normal anatomy and function, while seeking to avoid complications associated with other surgical approaches. We have performed more than 460 arterial switch procedures since 1990, and our surgeons have been at the forefront of a series of evolutionary operations.
As a quaternary, or subspecialty referral center, a large proportion of the babies transferred to us either pre- or post-natally have complex transposition forms, involving transposition of the great arteries and either a Ventricular Septal Defect (VSD) or aortic arch problems such as aortic coarctation or Taussig-Bing anomaly. We also see an unusually large proportion of low birthweight babies with transposition.
Our survival rates following the Arterial Switch Operation set world-class standards – most notably, in 2013, 2015, and 2016 100%
Total Arterial Switch Operation Volume = 81 2013-2016 |
NewYork-Presbyterian | STS National Benchmark |
| Overall Hospital Discharge Mortality Rate | 1.2% | 4.0% |