Executive Summary
2021 Data Summary
This report provides an overview of the RNSH Cardiac Surgery Department’s activity and achievements throughout 2021. The 2021 year was a mixed period for the department, particularly with the COVID-19 Delta outbreak halting elective surgery in early August. This resulted in 67 elective cardiac surgery patients being transferred to North Shore Private Hospital for surgery. The data collected and information available for this transferred patient cohort was limited and, therefore, has not been included in this report. The majority (77.2%) of RNSH cardiac surgery patients treated during the 12-month period were from either the Northern Sydney Local Health District (NSLHD) (31.2%) or Central Coast Local Health District (CCLHD) (46.0%). The remaining 22.8% of patients came from various locations across NSW, and interstate. Males aged between 60 and 79 years were the largest cohort of patients treated. In total, the department performed 352 cardiac surgery cases at RNSH. Of these, 49.7% were elective, 40.6% were urgent, 8.8% were emergency, and 0.9% were salvage cases. Isolated coronary artery bypass graft (CABG) surgery continued to be the most commonly performed procedure with 171 cases (48.6%), followed by 57 isolated heart valve repair/replacement procedures (16.2%), and 28 combination CABG/valve procedures (8.0%). The proportion of re-do operations was 6.8%, which is consistent with past reporting periods. The year saw the promising option of robotic cardiac and thoracic surgery being made available to RNSH patients at North Shore Private Hospital. The majority of patients underwent coronary artery bypass using the Left Internal Mammary Artery (LIMA). Thymectomy cases were also performed. A highlight for the department this year was Dr David Marshman being named an inaugural recipient of the Ray Hollings Surgical Excellence Award, which aims to encourage and support consultant surgeons to undertake quality improvement projects that support innovation and improve service delivery and patient care. The quality
improvement project application that Dr Marshman submitted on behalf of the Cardiothoracic Surgery Department was a study of perioperative blood product usage in RNSH cardiothoracic surgery. Dr Marshman received $4,600 in funding from the award, which will be used to support the project. In 2020, the department received two years’ sponsorship funding to establish a Cardiac Implantable Electronic Device (CIED) database. We continued work on this in 2021 and have now instituted a prospective Cardiac Electronic Devices (CIED) database using the Research Electronic Data Capture (REDCap) platform. In 2021, the RNSH Cardiac Surgery Department also continued contributing to the Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) Database Program. The aims of this program are to standardise surgical and clinical data collection for cardiac surgery cases and to report on performance standards at the individual, unit, state and national level. While this report focuses on cardiac surgery provided at RNSH, the unit also provides a comprehensive thoracic surgery service including advanced surgical resection in thoracic oncology and managing complex thoracic infections and other pathologies. RNSH thoracic surgery currently contributes to trials in the management of early stage non-small cell lung cancer. Our new thoracic surgical database is in its inception, and will become established in 2022. The team of dedicated staff are very proud to present the data within this report, which demonstrates the high quality cardiac surgery service being provided by the RNSH Cardiothoracic Surgery Department to the local community and beyond. Despite a challenging year due to COVID-19, the department continued to remain engaged and productive. We look forward to continuing to lead the way in providing cardiac surgery in 2022.
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Cardiac Surgery Annual Report 2021
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