Thorac Cardiovasc Surg 2021; 69(04): 294-307
DOI: 10.1055/s-0041-1730374
Original Cardiovascular

German Heart Surgery Report 2020: The Annual Updated Registry of the German Society for Thoracic and Cardiovascular Surgery

Andreas Beckmann
1   German Society for Thoracic and Cardiovascular Surgery, Langenbeck-Virchow-Haus, Berlin, Germany
,
Renate Meyer
2   BQS Institute for Quality and Patient Safety, Hamburg, Germany
,
Jana Lewandowski
1   German Society for Thoracic and Cardiovascular Surgery, Langenbeck-Virchow-Haus, Berlin, Germany
,
Andreas Markewitz
1   German Society for Thoracic and Cardiovascular Surgery, Langenbeck-Virchow-Haus, Berlin, Germany
,
Jan Gummert
3   Clinic for Thoracic and Cardiovascular Surgery, Heart and Diabetes Center NRW, Bad Oeynhausen, Germany
› Author Affiliations

Abstract

Based on a longtime voluntary registry, founded by the German Society for Thoracic and Cardiovascular Surgery (GSTCVS) in 1980, well-defined data of all cardiac, thoracic and vascular surgery procedures performed in 78 German heart surgery departments during the year 2020 are analyzed. Under the more than extraordinary conditions of the ongoing worldwide coronavirus disease 2019 pandemic, a total of 161,817 procedures were submitted to the registry. A total of 92,809 of these operations are summarized as heart surgery procedures in a classical sense. The unadjusted in-hospital survival rate for the 29,444 isolated coronary artery bypass grafting procedures (relationship on-/off-pump 3.6:1) was 97.2%. For the 35,469 isolated heart valve procedures, (17,471 transcatheter interventions included), the survival rate was 96.7%. Concerning short- and long-term circulatory support, a total of 2,852 extracorporeal life support/extracorporeal membrane oxygenation implantations, respectively, 843 assist device implantations (left/right/biventricular assist device, total artificial device), were registered. In 2020, the number of isolated heart transplantations increased to 340, a rise of 2.1% compared with the previous year. The isolated lung transplantations amounted to 291, a decrease of 6.4%.

This annually updated registry of the GSTCVS represents voluntary public reporting by accumulating actual information for nearly all heart surgical procedures in Germany, constitutes advancements in heart medicine, and represents a basis for quality management for all participating institutions. In addition, the registry demonstrates that the provision of cardiac surgery in Germany is up to date, appropriate, and nationwide patient treatment is guaranteed all the time.



Publication History

Received: 26 April 2021

Accepted: 26 April 2021

Article published online:
27 June 2021

© 2021. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 
  • References

  • 1 Rodewald G, Polonius MJ. Cardiac surgery in the Federal Republic of Germany during 1978 and 1979. Thorac Cardiovasc Surg 1980; 28 (06) 373-377
  • 2 Rodewald G, Kalmar P. Cardiac surgery in the Federal Republic of Germany during 1984. Thorac Cardiovasc Surg 1985; 33 (06) 397-399
  • 3 Kalmar P, Irrgang E. Cardiac surgery in the Federal Republic of Germany during 1988. Thorac Cardiovasc Surg 1989; 37 (03) 193-195
  • 4 Kalmar P, Irrgang E. Cardiac surgery in the Federal Republic of Germany during 1989. A report by the German Society for Thoracic and Cardiovascular Surgery. Thorac Cardiovasc Surg 1990; 38 (03) 198-200
  • 5 Gummert JF, Funkat A, Krian A. Cardiac surgery in Germany during 2004: a report on behalf of the German Society for Thoracic and Cardiovascular Surgery. Thorac Cardiovasc Surg 2005; 53 (06) 391-399
  • 6 Funkat AK, Beckmann A, Lewandowski J. et al. Cardiac surgery in Germany during 2011: a report on behalf of the German Society for Thoracic and Cardiovascular Surgery. Thorac Cardiovasc Surg 2012; 60 (06) 371-382
  • 7 Beckmann A, Meyer R, Lewandowski J, Markewitz A, Harringer W. German Heart Surgery Report 2018: the annual updated Registry of the German Society for Thoracic and Cardiovascular Surgery. Thorac Cardiovasc Surg 2019; 67 (05) 331-344
  • 8 Baumgartner H, Falk V, Bax JJ. et al; ESC Scientific Document Group. 2017 ESC/EACTS guidelines for the management of valvular heart disease. Eur Heart J 2017; 38 (36) 2739-2791
  • 9 Nishimura RA, Otto CM, Bonow RO. et al. 2017 AHA/ACC Focused Update of the 2014 AHA/ACC guideline for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation 2017; 135 (25) e1159-e1195
  • 10 Nishimura RA, O'Gara PT, Bavaria JE. et al. 2019 AATS/ACC/ASE/SCAI/STS Expert Consensus Systems of Care Document: a proposal to optimize care for patients with valvular heart disease: a joint report of the American Association for Thoracic Surgery, American College of Cardiology, American Society of Echocardiography, Society for Cardiovascular Angiography and Interventions, and The Society of Thoracic Surgeons. Ann Thorac Surg 2019; 107 (06) 1884-1910
  • 11 Otto CM, Nishimura RA, Bonow RO. et al. 2020 ACC/AHA guideline for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation 2021; 143 (05) e72-e227
  • 12 Richtlinie zu minimalinvasiven Herzklappeninterventionen; Richtlinie über Maßnahmen zur Qualitätssicherung bei der Durchführung von minimalinvasiven Herzklappeninterventionen gemäß § 136. Absatz 1 Satz 1 Nummer 2 für nach § 108 SGB V zugelassene Krankenhäuser MHI-RL; Gemeinsamer Bundesausschuss (G-BA): https://www.g-ba.de/richtlinien/84/
  • 13 Beckmann A, Hamm C, Figulla HR. et al; GARY Executive Board. The German Aortic Valve Registry (GARY): a nationwide registry for patients undergoing invasive therapy for severe aortic valve stenosis. Thorac Cardiovasc Surg 2012; 60 (05) 319-325
  • 14 Ensminger S, Fujita B, Bauer T. et al; GARY Executive Board. Rapid deployment versus conventional bioprosthetic valve replacement for aortic stenosis. J Am Coll Cardiol 2018; 71 (13) 1417-1428
  • 15 Fujita B, Ensminger S, Bauer T. et al; GARY Executive Board. Trends in practice and outcomes from 2011 to 2015 for surgical aortic valve replacement: an update from the German Aortic Valve Registry on 42 776 patients. Eur J Cardiothorac Surg 2018; 53 (03) 552-559
  • 16 Husser O, Fujita B, Hengstenberg C. et al; GARY Executive Board. Conscious sedation versus general anesthesia in transcatheter aortic valve replacement: the German Aortic Valve Registry. JACC Cardiovasc Interv 2018; 11 (06) 567-578
  • 17 Werner N, Zahn R, Beckmann A. et al. Patients at intermediate surgical risk undergoing interventional or surgical aortic valve implantation for severe aortic stenosis: one year results from the German Aortic Valve Registry. Circulation 2018; 138: 2611-2623
  • 18 Bekeredjian R, Szabo G, Balaban Ü. et al. Patients at low surgical risk as defined by the Society of Thoracic Surgeons Score undergoing isolated interventional or surgical aortic valve implantation: in-hospital data and 1-year results from the German Aortic Valve Registry (GARY). Eur Heart J 2019; 40 (17) 1323-1330
  • 19 Fujita B, Schmidt T, Bleiziffer S. et al; GARY Executive Board. Impact of new pacemaker implantation following surgical and transcatheter aortic valve replacement on 1-year outcome. Eur J Cardiothorac Surg 2020; 57 (01) 151-159
  • 20 Blumenstein J, Möllmann H, Bleiziffer S. et al. Transcatheter aortic valve implantation in nonagenarians: insights from the German Aortic Valve Registry (GARY). Clin Res Cardiol 2020; 109 (09) 1099-1106
  • 21 Voigtländer L, Twerenbold R, Schäfer U. et al; GARY Executive Board. Prognostic Impact of Underweight (Body Mass Index <20 kg/m2) in patients with severe aortic valve stenosis undergoing transcatheter aortic valve implantation or surgical aortic valve replacement (from the German Aortic Valve Registry [GARY]). Am J Cardiol 2020; 129: 79-86
  • 22 Abdel-Wahab M, Fujita B, Frerker C. et al; GARY Executive Board. Transcatheter versus rapid-deployment aortic valve replacement: a propensity-matched analysis from the German Aortic Valve Registry. JACC Cardiovasc Interv 2020; 13 (22) 2642-2654
  • 23 Färber G, Bleiziffer S, Doenst T. et al; GARY Executive Board. Transcatheter or surgical aortic valve implantation in chronic dialysis patients: a German Aortic Valve Registry analysis. Clin Res Cardiol 2021; 110 (03) 357-367
  • 24 Gammie JS, Zhao Y, Peterson ED, O'Brien SM, Rankin JS, Griffith BPJ. J. Maxwell Chamberlain Memorial Paper for adult cardiac surgery. Less-invasive mitral valve operations: trends and outcomes from the Society of Thoracic Surgeons Adult Cardiac Surgery Database. Ann Thorac Surg 2010; 90 (05) 1401-1408 , 1410.e1, discussion 1408–1410
  • 25 Herbert MA, Prince SL, Williams JL, Magee MJ, Mack MJ. Are unaudited records from an outcomes registry database accurate?. Ann Thorac Surg 2004; 77 (06) 1960-1964 , discussion 1964–1965
  • 26 Neumann FJ, Sousa-Uva M, Ahlsson A. et al; ESC Scientific Document Group. 2018 ESC/EACTS Guidelines on myocardial revascularization. Eur Heart J 2019; 40 (02) 87-165
  • 27 Bundesärztekammer (BÄK). Kassenärztliche Bundesvereinigung (KBV), Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften (AWMF)Nationale VersorgungsLeitlinie Chronische KHK. https://www.leitlinien.de/nvl/khk [cited: 2020–04–11].