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Congenital Heart Center Best Outcomes 35% better outcomes than established national benchmarks 85% survival at one year for Norwood procedure after first and second single-ventricle palliation Over 750 pediatric and adult congenital heart surgeries annually Contents About NewYork-Presbyterian & Our Congenital Heart Center 4 Center Overview 5 Outcomes 2013-2016 22 • Neonatal Cardiac Surgery < 30 Days 23 Norwood Procedure 24 Arterial Switch Operation (ASO) 25 • Tetralog of Fallot 26 • Atrial Septal Defect Repair (ASD) 27 • Ventricular Septal Defect Repair (VSD) 28 • Atrioventricular Canal Defect (AV Canal) 29 • Aortic Valve/Ross Procedure 30 • Valve Repair 31 • Transcatheter Pulmonary Valve Replacement 32 • Pediatric Transplant & Mechanical Assist Devices 33 • Adult Congenital Heart Surgery 34 Meet Our Team 35 We consistently rank as the best in pediatric care in the New York Tri-State region, with the lowest mortality for pediatric heart surgery in the state. < 1 > Ralf J. Holzer, MD, Julie A. Vincent, MD and Emile A. Bacha, MD Message from the Directors Dear Colleague: Each year, pediatric cardiac surgeons and interventional cardiologists at the NewYork- Presbyterian Congenital Heart Center perform more than 750 pediatric and congenital heart defect operations, including some 25 heart transplants, 175 newborn heart repairs, 1,500 interventional and diagnostic transcatheter procedures, and 100 adult congenital heart repairs. We have been performing pediatric heart surgery at a high volume since the early 1970s, creating a culture of clinical excellence and demanding the best outcome for every patient. We are proud to point to the fact that for seventeen years in a row, we have achieved significantly better outcomes than our peers in New York State. We performed the first successful pediatric heart transplant in the United States in 1984. We use 3-D printed heart models as part of pre-op management, allowing careful study of complex congenital heart disease lesions prior to surgical or transcatheter interventions. Our interventional cardiologists perform highly complex cardiac catheterization procedures in state-of-the-art cardiac catheterization laboratories with excellent outcomes. < 2 > The seamless integration of our Pediatric Cardiology and Cardiac Surgery Divisions begins prior to birth of the fetus, at the first consultation with a NewYork-Presbyterian surgeon or interventional cardiologist. Patients who require intervention receive continuity of care throughout their treatment and recovery. As a major national and international referral center for children and adults with congenital heart disease, NewYork-Presbyterian offers a physician access transfer program – 1-800-NYP-STAT – to coordinate patient transfers when tertiary and quaternary care are required. On behalf of NewYork-Presbyterian Congenital Heart Center, we are pleased to provide a summary of outcomes for some of our most often performed pediatric and adult cardiac congenital surgical and catheterization procedures for the years 2013-2016, the most recent period for which complete data are available. Data are presented in accordance with the Society of Thoracic Surgeons (STS) congenital cardiac surgery database guidelines. We hope you will find the information in this brochure valuable as you make informed decisions as to where to refer your pediatric cardiac patients for surgery. Message from the Directors Sincerely, Emile A. Bacha, MD Julie A. Vincent, MD, FACC, FSCAI, FAAP Ralf J. Holzer, MD, MSc, FACC, FSCAI Chief, Cardiac, Thoracic and Vascular Alexandra and Steven Cohen Chief of Pediatric Chief, Pediatric Cardiology Surgery Cardiology NewYork-Presbyterian/Weill Cornell Medical Center NewYork-Presbyterian/Columbia University NewYork-Presbyterian / Columbia University Medical Center Medical Center Director , Pediatric Cardiac Catheterization NewYork-Presbyterian Komansky Children’s Hospital Director, Congenital and Pediatric Cardiac Surgery Samberg Scholar in Children’s Health NewYork-Presbyterian NewYork-Presbyterian Morgan Stanley Co-Director Children’s Hospital NewYork-Presbyterian Congenital Heart Center Co-Director NewYork-Presbyterian Congenital Heart Center Co-Director David Wallace-Star Professor of Pediatric Cardiology NewYork-Presbyterian Congenital Heart Center Weill Cornell Medicine Calvin F. Barber Professor of Surgery Vagelos College of Physicians and Surgeons Welton M. Gersony Professor of Pediatric Cardiology Columbia University Vagelos College of Physicians and Surgeons Columbia University Adjunct Professor of Surgery Weill Cornell Medicine Adjunct Professor of Pediatrics Weill Cornell Medicine < 3 > About NewYork-Presbyterian & Our Congenital Heart Center We are comprised of two renowned medical centers: Morgan Stanley Children’s Hospital at NewYork-Presbyterian/ Columbia University Medical Center and Komansky Children’s The most important Hospital at NewYork-Presbyterian/Weill Cornell Medical Center. measure of a center’s We have built a national reputation for outstanding care devoted to children. The hospital experience & expertise in ranks in the top ten in the nation in pediatric cardiology and heart surgery, according to pediatric cardiovascular the 2017-2018 U.S. News & World Report “Best Children’s Hospitals” rankings. We have the lowest mortality rate in New York State for pediatric heart surgery, and one of the lowest surgery is the quality of nationwide – even though our surgeons routinely treat some of the most complex cases, its outcomes many referred from other institutions Our integrated Congenital Heart Center is one of the largest and most preeminent pediatric cardiology and cardiac surgery centers in the nation and one of the nation’s major pediatric transplant centers. We have a distinguished roster of highly-skilled and experienced cardiovascular surgeons, including four national leaders specializing in complex neonatal surgery, hybrid minimally invasive surgery and transplant/assist devices. A team of five highly skilled interventional cardiologists provide a full range of transcatheter interventions at both NewYork-Presbyterian locations — Morgan Stanley Children’s Hospital and Komansky Children’s Hospital. We offer our young patients cardiovascular expertise together with all sub-specialties that may be needed when treating a complex heart problem — from fetal diagnosis and therapies to neonatal pediatric cardiac intensive care, minimally invasive electrophysiology studies, non-invasive imaging, and specialized pediatric cardiac anesthesia. Our patients come to us from across the country and around the world to seek the most advanced, safest, and proven treatments for congenital heart conditions and for the revision of previous surgery when that treatment fails. We provide both adult and pediatric patients with congenital heart defects treatment options never thought possible just a short time ago. < 4 > Center Overview 2013-2016 Our outcomes are 35% better than national benchmarks Our average hospital mortality for the most complex neonatal procedures was 11.9 % compared to 17.0 % globally While we treat some of the most complex cases, our outcomes are well above established national benchmarks. It has been demonstrated that improved clinical outcomes are closely linked to centers with high surgical volumes. As a center’s activity increases, cardiothoracic surgeons, cardiologists, anesthesiologists, critical care specialists, nurses, perfusionists and other cardiac team members become more experienced caring for patients with congenital heart disease. < 5 > We Perform More Than 750 Pediatric and Adult Congenital Heart Surgeries NewYork-Presbyterian Pediatric & Adult Congenital Cardiac Surgeries 2013-2016 800 746 748 754 700 661 600 506 490 487 500 446 400 300 200 75 85 85 106 100 0 2013 2014 2015 2016 Total Open and Closed Congenital Heart Surgeries Pediatric Open Heart Surgeries Adult Congenital Cardiac Surgeries Neonatal Volume 2013-2016 2013 2014 2015 2016 Surgical Procedures (neonate <30 days) 103 146 127 153 < 6 > NewYork-Presbyterian Survival Statistics 2013-2016 Number of Cases I Survival Procedure 2013 2014 2015 2016 Aortic Valve/Ross 9 | 100% 12 | 100% 10 | 100% 12 | 100% Arterial Switch Operation (ASO) 13 | 100% 25 | 96% 17 | 100% 25 | 100% Atrial Septal Defect Repair (ASD) 62 | 100% 38 | 100% 41 | 100% 55 | 100% Atrioventricular Canal Defect (AV Canal) 29 | 97% 35 | 94% 16 | 100% 20 | 100% Fontan 21 | 91% 22 | 95% 25 | 100% 27 | 100% Glenn 16 | 100% 21 | 95% 26 | 96% 22 | 100% Norwood 16 | 82% 18 | 100% 14 | 86% 19 | 89% Tetralogy of Fallot Repair (TOF) 33 | 100% 50 | 100% 34 | 100% 35 | 97% Total Anomalous Pulmonary Venous Return 4 | 100% 16 | 94% 9 | 100% 14 | 100% (TAPVR) Transplant 30 | 93% 22 | 100% 26 | 100% 22 | 95% Ventricular Septal Defect (VSD) 37 | 100% 48 | 98% 50 | 100% 43 | 100% Overall Hospital Discharge Mortality Rate 2013-2016 NewYork-Presbyterian STS National Benchmark 2013 3.0% 3.2% 2014 2.5% 2.9% 2015 1.9% 3.1% 2016 2.8% 2.8% < 7 > We Perform More Than 1,300 Pediatric Cardiac Catheterization Procedures Annually NewYork-Presbyterian Pediatric & Adult Cardiac Catheterization Procedures 2013-2016 1,270 1,284 1,300 1,228 1,221 1,200 1,100 1,000 900 800 700 600 500 400 300 225 194 200 188 100 169 15 16 21 26 0 2013 2014 2015 2016 Total Pediatric & Adult Catheterization Cases Pediatric Therapeutic Catheterization Interventions* Adult Therapeutic Catheterization Interventions* * Because biopsies are considered NON-INTERVENTIONAL, numbers for pediatric and adult interventions in the
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