A. Funkat

Cardiac Surgery in Germany during 2010: A Report on Behalf of the German Society for Thoracic and Cardiovascular Surgery

All cardiac surgical procedures performed in 79 German cardiac surgical units throughout the year 2010 are presented in this report, based on a voluntary registry which is organized by the German Society for Thoracic and Cardiovascular Surgery. In 2010 a total of 95,734 cardiac surgical procedures (ICD and pacemaker procedures excluded) have been collected in this registry. More than 12.4% of the patients were older than 80 years compared to 11.8% in 2009. Hospital mortality in 42,804 isolated CABG procedures (14.2% off-pump procedures) was 2.8%. In 25,127 isolated valve procedures (including 3660 transcatheter-valve implantations) a mortality of 4.9% has been observed. This voluntary registry of the German Society for Thoracic and Cardiovascular Surgery will continue to be an important tool enabling quality control and illustrating the development of cardiac surgery in Germany.

Cardiac Surgery in Germany during 2007: A Report on Behalf of the German Society for Thoracic and Cardiovascular Surgery

All cardiac surgical procedures performed in 80 German cardiac surgical units throughout the year 2007 are presented in this report, based on a voluntary registry which is organized by the German Society for Thoracic and Cardiovascular Surgery. In 2007 a total of 99,990 cardiac surgical procedures (ICD and pacemaker procedures excluded) have been collected in this registry. More than 9.8% of the patients were older than 80 years compared to 9.6% in 2006. Hospital mortality in 49,788 isolated CABG procedures (10.1% off-pump) was 2.7%. In 21,312 isolated valve procedures a mortality of 5.1% has been observed. This voluntary registry of the German Society for Thoracic and Cardiovascular Surgery will continue to be an important tool enabling quality control and illustrating the development of cardiac surgery in Germany.

Cardiac surgery in Germany during 2008. A report on behalf of the German Society for Thoracic and Cardiovascular Surgery.

All cardiac surgical procedures performed in 79 German cardiac surgical units throughout the year 2008 are illustrated in this report, based on a voluntary registry which is organized by the German Society for Thoracic and Cardiovascular Surgery. In 2008 a total of 99 176 cardiac surgical procedures (ICD and pacemakers procedures excluded) have been collected. More than 10.3 % of the patients were older than 80 years compared to 9.8 % in 2007. Hospital mortality in 47 337 isolated CABG procedures (11.3 % off-pump) was 2.8 %. In 22 243 isolated valve procedures a mortality of 4.7 % has been observed. This voluntary registry of the German Society for Thoracic and Cardiovascular Surgery continues to be an important tool enabling quality control and illustrating the development of cardiac surgery in Germany.

Cardiac Surgery in Germany during 2009. A Report on Behalf of the German Society for Thoracic and Cardiovascular Surgery

All cardiac surgical procedures performed in 80 German cardiac surgical units throughout the year 2009 are presented in this report, based on a voluntary registry which is organized by the German Society for Thoracic and Cardiovascular Surgery. In 2009 a total of 96 129 cardiac surgical procedures (excluding ICD and pacemaker procedures) were collected in this registry. More than 11.8 % of the patients were older than 80 years compared to 10.3 % in 2008. Hospital mortality in 45 171 isolated CABG procedures (13.1 % off-pump) was 2.8 %. In 23 556 isolated valve procedures (including 2216 catheter-based procedures) a mortality of 4.7 % was observed. This voluntary registry of the German Society for Thoracic and Cardiovascular Surgery continues to be an important tool for quality control and illustrates the development of cardiac surgery in Germany.

Cardiac Surgery in Germany during 2013: A Report on Behalf of the German Society for Thoracic and Cardiovascular Surgery

On the basis of a voluntary registry of the German Society for Thoracic and Cardiovascular Surgery (GSTCVS), data of all cardiac surgical procedures performed in 79 German cardiac surgical units during the year 2013 are presented. In 2013, a total of 99,128 cardiac surgical procedures (implantable cardioverter defibrillator [ICD] and pacemaker procedures excluded) were submitted to the registry. More than 13.8% of the patients were older than 80 years, which remains equal in comparison to the previous year. In-hospital mortality in 40,410 isolated coronary artery bypass grafting procedures (84.5% on-pump and 15.5% off-pump) was 2.9%. In 29,672 isolated valve procedures (including 7,722 catheter-based procedures), an in-hospital mortality of 4.7% was observed. This long-lasting registry of the GSTCVS will continue to be an important tool for quality control and voluntary public reporting by illustrating current facts and developments of cardiac surgery in Germany.

German Heart Surgery Report 2015: The Annual Updated Registry of the German Society for Thoracic and Cardiovascular Surgery.

On the basis of a long-standing voluntary registry, which was founded by the German Society for Thoracic and Cardiovascular Surgery (GSTCVS), well-defined data of all heart, thoracic, and vascular surgery procedures performed in 78 German heart surgery departments during 2015 are analyzed. In 2015, a total of 103,967 heart surgery procedures (implantable cardioverter defibrillator, pacemaker, and extracardiac procedures without ECC excluded) were submitted to the database. Approximately 14.8% of the patients were at least 80 years old, resulting in an increase of 0.6% compared with the data of 2014. For 38,601 isolated coronary artery bypass grafting procedures (relationship on-/off-pump: 5:1), the unadjusted inhospital mortality was 2.7%. Concerning the 32,346 isolated heart valve procedures (including 10,606 catheter-based implantations) an unadjusted inhospital mortality of 4.4% was observed.This annual updated registry of the GSTCVS represents voluntary public reporting by accumulating actual information for nearly all heart surgical procedures in Germany, demonstrates advancements in heart medicine, and enables internal/external quality assurance for all participants. In addition, the registry demonstrates that the provision of heart surgery in Germany is appropriate and patients are treated nationwide in a round-the-clock service.

Quality Control and Learning Curves at the Heart Center Leipzig

For several years quality assurance has gained growing attention. De Leval was one of the first to outline the importance of analyzing human factors in cardiac surgery and of performing individual failure analyses.1,2 However, the usual means of descriptive statistics cannot be regarded sufficient in thisfield. The low numbers of particular operations per surgeon require additional analyses to detect changes in quality early. In this context, the usefulness of the sequential probability cumulative sum (CUSUM) technique to analyze surgical performance has been shown in recent publications.3–6 It allows detection of changes in perioperative mortality and morbidity already during the patient care process. It provides almost real-time monitoring of surgical performance if updated after each procedure. Also, CUSUM analysis acknowledges the importance of individual experience inmonitoring performance and allows easy charting of a learning curve with regards to the incidence of perioperative complications. The charts are intuitively readable, butcare isneeded toavoidmisinterpretation.7 Moreover, the charts can also beused to depict learning curves and are therefore helpful in accompanying new surgeons during their initial training or experienced surgeons in the learning process of a new method. In this article, we describe the developments in thefield of quality control at the Leipzig Heart Center during the past two decades. The foundation for these initiatives was the creation and maintenance of a comprehensive institutional and national database.

Erläuterungen und Kommentar zur aktuellen DGTHG-Leistungsstatistik (Verfahrensjahr 2007)

ZusammenfassungDie Leistungsstatistik der Deutschen Gesell schaft für Thorax-, Herz- und Gefäßchirurgie (DGTHG) wird seit 1978 erhoben und gibt einen vollständigen Überblick über die in den herzchirurgischen Kliniken Deutschlands durchgeführten Eingriffe. In diesem Artikel wird eine Einführung in die Systematik der Statistik gegeben und ein Teil der aktuellen Daten aus dem Verfahrensjahr 2007 vorgestellt.AbstractThe voluntary registry of the German Society for Thoracic and Cardiovascular Surgery annually collects data of all cardiac surgical procedures performed in all units in Germany. Since 1989 the data have been published in an annual report. The registry is an important tool enabling quality control and the ability to illustrate the development of cardiac surgery in Germany. The structure of the registry is explained and a summary of the data from 2007 are presented in this overview.