STS Benchmarking in Congenital Heart Disease Surgery in Argentina: Is Comparison Feasible?

Background: The Society of Thoracic Surgeons (STS) cardiac surgery database reports the outcomes of benchmark procedures in pediatric cardiac surgery (STS-CHSD).Its primary objective is to support quality improvement in pediatric cardiac surgery programs in North America by evaluating and reporting in-hospital mortality outcomes, expressed as interquartile ranges (IQRs), for the 10 benchmark procedures since 2012, at 5-year intervals.Objective: To evaluate the outcomes of an Argentine pediatric cardiovascular surgery unit for these 10 benchmark procedures by comparing them with those reported by the STS-CHSD.Methods: Using our pediatric cardiovascular surgery unit database, we identified all patients who underwent procedures defined as STS-CHSD benchmarks over the past 15 years and compared the local outcomes with the external, with their international interquartile ranges (IQRs).Results: A total of 412 patients who underwent surgery were identified, including 7 deaths, with the following results: mortality (STS IQR): 1) Surgical repair of aortic coarctation without cardiopulmonary bypass: 0% (0.0-1.71%); 2) ventricular septal defect (VSD) closure: 0% (0-0.78%); 3) tetralogy of Fallot repair: 1.8% (0-1.96%);4) complete atrioventricular (AV) canal repair: 1.88% (0 to 1.75%); 5) arterial switch operation for simple transposition of the great arteries (TGA): 0% (0 to 3.45%); 6) arterial switch operation for TGA with VSD closure: 10% (0 to 7.14%); 7) Glenn procedure: 1.69% (0 to 2.53%); 8) Fontan-Kreutzer procedure: 1.75% (0 to 1.84%); 9) truncus arteriosus repair: 0% (0 to 18.75%); and 10) Norwood procedure: 6.66% (5.77-15%).Conclusion: Our results are better or similar to STS CHSD.Only in 2 procedures are above the STS IQR, demonstrating the feasibility of using STS benchmarking in our country with excellent results.