The European Congenital Heart Surgeons Association congenital cardiac database: A 25-year summary of congenital heart surgery outcomes

Abstract OBJECTIVES The European Congenital Heart Surgeons Association Congenital Cardiac Database (ECHSA-CCDB), growing steadily over 25 years is the second largest in the world. In this study, we summarize overall outcomes of paediatric and congenital cardiac procedures, stratified by age groups, and the benchmark procedure groups, and we report on observed trends. METHODS All data from 1999 until August 2024 are analysed and outcome parameters hospital mortality (HM), 30-day mortality (30d-M) and length of stay are reported. Outcomes are stratified by the origin of participating centres, by age groups and by the standard 10 benchmark procedure groups. Important outcome trends are also demonstrated. RESULTS Over 25 years, 377 606 procedures in 294 206 patients of all ages with congenital heart disease were recorded. Overall 30d-M and HM, were 3.65% and 4.09%, respectively. The mean length of stay was 15.95 (SD 26.53) days. 30d-M and HM for neonates were 8.71% and 10.28%; for infants 3.36% and 3.90%; for children 1.68% and 1.87%; for adults 1.77% and 1.85%, respectively. For benchmark procedure groups, 30d-M and HM ranged from 0.63% and 0.72% for ventricular septal defect repair to 22.93% and 27.62% for the Norwood procedure. Reduced mortality over time was documented across the board. CONCLUSIONS This 25-year report provides real-world outcomes of paediatric and adult congenital heart surgery in participating ECHSA-CCDB centres, unadjusted overall and stratified by age and benchmark procedure groups. Mortality has been decreasing over time. This information can be of value for research and individual centre quality improvement programs.