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Editorials

Guidelines for Reporting Mortality and Morbidity After Cardiac Valve Interventions—Need for a Reappraisal? (Response)

^a Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts
^b Department of Thoracic and Cardiovascular Surgery, Heart and Vascular Institute, The Cleveland Clinic Foundation, Cleveland, Ohio
^c Department of Cardiovascular and Thoracic Surgery, Stanford University School of Medicine, Stanford, California
^d Cardiac, Thoracic and Vascular Surgery Inc, St. Louis, Missouri
^e Department of Surgery, University Hospital Zurich, Zurich, Switzerland

^_* Address correspondence to Dr Akins, Massachusetts General Hospital, Cardiac Surgery - White 503, 55 Fruit St, Boston, MA 02114 (Email: cakins@partners.org).

The first 20% of the full text of this article appears below.

	Introduction

 
Piazza and colleagues have provided a thoughtful and thought-provoking response to our recently published "Guidelines for Reporting Mortality and Morbidity After Cardiac Valve Interventions" [1] that focuses particularly on their application to the burgeoning field of percutaneous valve interventions. They listed four points that they believe require further discussion: (1) morbidity definitions, (2) approach-specific outcome measures, (3) composite end points, and (4) implications for transcatheter therapy. We will try to address their concerns about each of these issues.

	Morbidity Definitions

 
As a general comment: For what we thought were valid reasons, the current guidelines intentionally do not provide rigorous, complete definitions of each complication. Definitions that are too specific risk becoming rapidly antiquated in the face of both advancing technology and ongoing work of other bodies that establish standards, such as the Society of Thoracic Surgeons National Database Committee, charged with such definitions. For example, Piazza and colleagues mention the new definition of myocardial infarction [2]. If that document had been written when the best available enzyme determination was the myocardial fraction of creatine kinase, . . . [Full Text of this Article]

Related Article

Guidelines for Reporting Mortality and Morbidity After Cardiac Valve Interventions—Need for a Reappraisal?

Nicolo Piazza, Yoshinobu Onuma, Peter de Jaegere, and Patrick W. Serruys
Ann. Thorac. Surg. 2009 87: 357-358. [Extract] [Full Text] [PDF]

This article has been cited by other articles:

				M. B. Leon, N. Piazza, E. Nikolsky, E. H. Blackstone, D. E. Cutlip, A. P. Kappetein, M. W. Krucoff, M. Mack, R. Mehran, C. Miller, et al. Standardized Endpoint Definitions for Transcatheter Aortic Valve Implantation Clinical Trials: A Consensus Report From the Valve Academic Research Consortium J. Am. Coll. Cardiol., January 18, 2011; 57(3): 253 - 269. [Abstract] [Full Text] [PDF]

				M. B. Leon, N. Piazza, E. Nikolsky, E. H. Blackstone, D. E. Cutlip, A. P. Kappetein, M. W. Krucoff, M. Mack, R. Mehran, C. Miller, et al. Standardized endpoint definitions for transcatheter aortic valve implantation clinical trials: a consensus report from the Valve Academic Research Consortium Eur. Heart J., January 6, 2011; (2011) ehq406v2. [Abstract] [Full Text] [PDF]

				L. H. Edmunds Jr Editor's Note. Ann. Thorac. Surg., February 1, 2009; 87(2): 360 - 360. [Full Text] [PDF]