Abstract
Electrophysiologic (EP) and structural interventions in adult congenital heart disease (ACHD) are typically completed during separate hospital encounters. With planning/coordination, these cases can be combined. We hypothesized that this integrated approach would yield patient and health system benefits. Consecutive ACHD patients undergoing combined interventions were matched to controls with identical but separate procedures. Primary endpoints of total hospital length of stay and cost were compared. Sixty-six combined cases and 120 controls were identified (45% male, mean age 36.2 ± 14.2 years). The most common diagnoses were Fontan (27%), tetralogy of Fallot (23%), and transposition complexes (20%). The most common EP procedure was catheter ablation (n = 30) followed by electrophysiologic study (n = 13); the most common structural intervention was transcatheter valve replacement (n = 16) followed by angioplasty/stenting (n = 14). Compared to controls, cases showed shorter anesthesia duration (323 [IQR 238-405] vs. 355 minutes [270-498], P = 0.06), smaller contrast dose (130 [50-189] vs. 177 mL [94-228], P = 0.045), fewer venipunctures (4 [3-4] vs. 6 [5-7], P < 0.001), and fewer work days missed (2 [2-5] vs. 4 [4-6], P < 0.001...Continue Reading
References
Mar 14, 2007·The American Journal of Cardiology·Andrew S MackieAriane J Marelli
Nov 29, 2008·Journal of the American College of Cardiology·Carole A WarnesGary D Webb
Oct 14, 2009·Circulation·Judith BouchardyAriane J Marelli
May 21, 2013·Circulation. Arrhythmia and Electrophysiology·Akiko UedaSabine Ernst
May 3, 2014·Journal of Cardiovascular Electrophysiology·Jeremy P Moore, Kevin M Shannon
Sep 30, 2014·The Canadian Journal of Cardiology·Paul KhairyCarole A Warnes
Oct 4, 2014·Journal of Cardiothoracic and Vascular Anesthesia·Bryan G MaxwellAlan Cheng
Oct 28, 2014·Congenital Heart Disease·Osamah AldossAbhay Divekar
Dec 17, 2014·Journal of the American College of Cardiology·John W MooreUNKNOWN NCDR IMPACT Steering Committee
Jun 25, 2015·Circulation. Arrhythmia and Electrophysiology·Jeremy P MooreKevin M Shannon
Sep 16, 2015·Circulation·Gerhard-Paul DillerMichael A Gatzoulis
Oct 21, 2015·Circulation·Natalie JayaramLisa Bergersen
Jan 1, 2016·JACC. Cardiovascular Interventions·Fabien PrazPeter Wenaweser
Jan 9, 2016·Journal of Interventional Cardiac Electrophysiology : an International Journal of Arrhythmias and Pacing·Ulrich KrauseThomas Paul
Feb 26, 2016·Current Cardiology Reports·Joanna Ghobrial, Jamil Aboulhosn
Jul 7, 2016·Circulation·Suzanne M GilboaAriane J Marelli
Jan 13, 2017·European Heart Journal·Jose Maria OliverFrancisco Fernandez-Aviles
Feb 14, 2017·Pacing and Clinical Electrophysiology : PACE·S Yukiko AsakiAthar M Qureshi
Apr 22, 2017·European Heart Journal·Ada C Stefanescu SchmidtAmi B Bhatt