Tuesday, June 23, 2009

AHA grant awarded for congenital heart defect study
By Kelly Shaw, DCRI Communications

New DCRI faculty member Sara Pasquali, MD, was recently awarded a two-year grant from the American Heart Association. The $100,000 grant is funding a study that will evaluate if the number of congenital heart patients a center treats has an impact on survival rate.

Pasquali has been at the DCRI since August 2008.

Congenital heart defects are the most common birth defects. In the most severe cases, the whole left side of the heart may not develop. This is known as hypoplastic left heart syndrome. This type of heart defect carries the highest risk of death during the first year of life of any congenital heart defect. Although survival has improved in recent years due to improvements in surgical techniques and care for these infants, there is still a high risk of post-operative complications and death.

Previous studies have suggested that centers that treat a lower number of these complex congenital heart patients might have poorer outcomes. The new study, which will be led by Dr. Pasquali, will be the first to use a large multicenter clinical database to assess if center volume does impact patient outcomes. The study will begin in July, and Pasquali anticipates that results will be available within the grant's two years.

Researchers will analyze data from the Society of Thoracic Surgeons Congenital Heart Surgery Database. It is the largest database of its kind for congenital heart defects, and contains data on more than 120,000 patients at 71 centers in the United States who had operations for congenital heart problems.

“We have several key goals for this study,” said Pasquali. “We will evaluate the impact of center volume on patient outcome taking into account certain factors about the patient and operation. If we find that patients who have surgery at bigger centers fare better, we will estimate how referral of patients to larger centers would potentially impact overall survival rates. We will also investigate whether there are differences in how larger centers provide care for these patients, which may help us to improve the quality of care for all patients undergoing surgery for this type of heart defect.”

The DCRI's Eric Peterson, MD, and Jennifer Li, MD, will also be involved in the study.