National Registry of Cardiovascular Surgery in Argentine
Conditions: Cardiovascular Diseases, Surgery
Sponsor: Sociedad Argentina de Cardiología

1 
Research protocol 
4th National Registry of 
Cardiovascular Surgery (CCV) in Argentina 
-Version N ° 3- 8 of JULY 2021 
 
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Confidentiality notice: The concepts and information included in this document are confidential 
and exclusive and not 
they must be disclosed in whole or in part without the express written consent of the coordinator. 
 
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PROTOCOL SUMMARY 
➢ Title 
1- Prospective registry of patients undergoing CCV in Argentina 
➢ Study Phase 
1- Prospective Registry (IV) 
➢ Evaluation 
1- Follow-up of patients during hospitalization and 30 days after surgery. 
➢ Primary Objectives 
1.a. 
Determine the evolution and surgical complications in patients undergoing CCV 
1 B. 
To determine the association between different risk variables during the intranosocomial stay and at 30 
days of discharge including nosocomial readmission during the 30-day follow-up. 
➢ Secondary Objectives 
To determine the association between different variables that occurred before, during and after the 
surgical intervention. 
To determine the association between different variables of risk at discharge and the rate of 
complications, including 
mortality and readmissions during the 30 days following discharge, such as: 
Cardiovascular mortality, all-cause mortality, rehospitalization, infectious complications. 
To determine the association between different variables with cardiovascular mortality in relation to 
CCV. 
Assess eventual complications 30 days after hospital discharge 
 
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➢ Study Design 
National, multicenter, analytical, prospective cohort study for prognostic evaluation in patients 
undergoing 
cardiovascular surgery (CCV) 
➢ Sample Size 
The largest number of patients (between 2000 and 3000) will be enrolled during a set period of time (1 
year), from 
October 1, 2020 to September 30, 2021 
➢ Eligibility Criteria 

Over 18 years 


Myocardial revascularization surgery 

Valvular surgeries 

Ascending Aortic Surgery 

Type A Aortic Dissection Surgery 

Combined surgery 
➢ Exclusion Criteria 

Cardiovascular surgery for congenital pathologies 

Peripheral vascular surgery 

Cardiovascular surgery secondary to trauma 

Thoracic and abdominal aorta pathology 

Other surgeries 
➢ Procedures 
Various centers are included nationwide with a CCV service capable of admitting and intervening 
patients with 
criteria already established. 
They are arranged below: 
Leben Health 
Private Hospital Santa Clara de Asis 
Dr Alberto Duhau Hospital 
Pasteur Clinic 
Sanatorio Juan XXIII 
Private hospital 
San Martin Sanatorium 
Cordoba Hospital 
Spanish Hospital 
Spanish Hospital / Pami 2 Polyclinic / Italian Hospital / IPAM 
Santa Clara Clinic 
CARDIOMED 
Cosme Argerich Hospital 
Spanish Society of Mutual Aids 
CCV- St. Clara San Juan 
 
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Tucuman Institute of Heart Diseases 
Italian Hospital of Mendoza 
FIG Dr. Oscar Alende 
HOSPITAL FOUNDATION / CENTRAL MILITARY HOSPITAL 
Spanish Hospital 
Galen Sanatorium 
San Juan de Dios Hospital 
Guemes sanatorium 
Dr. Cesar Milstein Hospital 
CEMIC 
HIEAYC SAN JUAN DE DIOS 
Sanatorio de la Cañada 
Hospital de Clinicas Jose de San Martin 
South Mendocino Spanish Hospital 
Sanatorium of La Trinidad Miter 

La Sagrada Familia Clinic 
ICBA 
Santorio de la Trinidad Quilmes 
British Sanatorium of Rosario 
Bazterrica 
Santa Isabel Clinic 
Htal Churruca 
Sanatorio Del Salvador 
Sanatorio Anchorena San Martin 
Carrillo Hospital 
Sanatorium San Juan Bautista 
Sanatorio Juan XXIII 
Sanatorio Juan XXIII 
Argerich Hospital 
Argerich hospital 
HIGA President Peron 
Spanish Hospital Buenos Aires 
Belgrano Adventist Clinic 
German Hospital 
Syrian Lebanese Hospital 
BRITISH Hospital 
Favaloro Foundation 
Private Clinic velez sarsfield 
Yunes Clinic 
Hospital Italiano De Bs.As. 
Juan Domingo Peron High Complexity Hospital 
Allende Sanatorium 
Sanatorio de la Cañada 
Cardiology institute 
British sanatorium 
Htal Eduardo Wilde 
Presidente Peron Hospital 
Hospital El Cruce 
Private hospital 
Pasteur Clinic 
Hospital Escuela de Agudos Ramon Madariaga 
Bernal Sanatorium 
San Roque Sanatorium 
Spanish society and clinic santa clara mendoza 
 
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Cesar Milstein Hospital 
San Luis Cardiovascular Institute 
Galen Sanatorium 
ICBA 
Instituto de Cardiologia de Rosario "Dr. Luis Gonzalez Sabathie" 
Malvinas Argentinas Sanitary Pole 
Delta Sanatorium 
Sanatorio Dr Julio Mendez 
Model Institute of Cardiology 
Sanatorio San Jorge SRL 
policlinico san lucas / clinica regional del sud 
Private Hospital of the Mar del Plata Community 
SANTA FE SANATORIO MEDICO SURGICO 
Zabala SMG Clinic 
Decentralized Public Hospital Dr Guillermo Rawson 
Patients are evaluated during hospitalization eligibility criteria and the Informed Consent will be signed. 
(CI) according to current regulations. 

The respective filling of the files designed with the necessary Pre-surgical data will be carried out, during 
the 
surgical procedure and postoperative. 
Telephone calls will be made from the Argentine Society of Cardiology (SAC) and / or College of 
Cardiovascular Surgeons (CCV), with a questionnaire 30 days after discharge. 
The principal investigators of the study are: 
Dr Esteban Romeo 
Dr Adrián Lescano 
It will be assigned during the inclusion of investigator patients for each of the centers, who will be 
responsible for completing the form ( CRF ) and sending the registered data. 
 
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Additional Information 
Introduction 
More than ten years have passed since the last CCV registration in the Argentine Republic 
In recent decades, the evolution of CCV has shown a reduction in the rate of complications and mortality 
in centers 
specialized 
objectives 
Record 
1. determine complications, mortality and hospital stay, as well as evolution at 30 days after CVD 
In our country 
2. Compare our variables with those exposed by the different international scores and thus be able to 
predict the 
estimated evolution of our patients. 
Substudy 
1. Determine the association between different variables, complication rate and mortality 30 days after 
discharge. 
Proposed design 
The study consists of 2 stages , with the voluntary participation of the different centers, which is divided 
into nosocomial phase and phase a 
30 days after discharge 
Prospective multicenter registry of prognostic correlation with various risk scores in patients undergoing 
CCV and 
evolution of the same 30 days after discharge 
Material and methods 
Patients who meet the eligibility criteria described above are included from October 1, 2020 
The protocol consists of 2 stages: 
1) Nosocomial Phase: a descriptive record is made of the referred variables and the risk parameters upon 
discharge from 
the patients 
2) 30 days after discharge, the respective forms will be filled out for the final evaluation of 
patients who have undergone CCV and discharged from participating institutions 
 
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Specific Protocol (Operational Definition of 
Variables): 
A complete clinical history of the patient is taken (according to usual practice) and the data is filled out in the 
Pre, Intra and Post-surgical stage according to what is established in the form 

Affiliate Information and Background 
Record ID 
__________________________________ 
Date of admission 
__________________________________ 
Acronyms for Name and Surname 
__________________________________ 
Last 3 digits of document number 
__________________________________ 
(Last 3 digits only) 
Age ______ gender_____ Weight (kg) ______ Height (cm) ______ 
Public Hospital Coverage 
PAMI 
Social work 
Prepaid 
Particular 
Telephone 
__________________________________ 
Phone 2 
__________________________________ 
Email 
__________________________________ 
Background 
Arterial hypertension Yes No 
Diabetes Yes No 
Diabetic retinopathy Yes No 
Dyslipidemia Yes No 
Ex-smoker tobacco 
I never smoke 
Smokes daily 
Smokes occasionally 
It is unknown 
 
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Hyperuricemia Yes No 
HIV Yes No 
Systolic LV dysfunction Yes No 
Heart failure Yes No 
Myocardial infarction No <30 days> 30 days 
Myocardial revascularization surgery Yes No 
Valve surgery Yes No 
Other cardiovascular surgery Yes No 
Type of cardiovascular surgery 
__________________________________ 
(Describe ...) 
Coronary angioplasty Yes No 
Immunocompromise Yes No 
Mediastinal radiation Yes No 
Stable chronic angina Yes No 
Chronic atrial fibrillation Yes 
No 
Unstable angina Yes No 
Family history of coronary disease Yes No 
Peripheral vascular disease Yes No 
Pulmonary Hypertension Yes No 
Cerebrovascular disease Yes No 
Syncope Yes No 
SAHOS Yes No 
COPD No 
Mild 
Moderate 
Severe 
It is unknown 

Remote Non-Recent Pneumonia 
It is unknown 
Did you have COVID-19 within the month prior to surgery? If not 
Liver disease Yes No 
Illicit drug use No Recent Remote 
It is unknown 
Alcohol abuse No 
<1 glass per day 
2 to 7 glasses per day 
> 7 glasses per day 
It is unknown 
Usual medication Aspirin 
 
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Clopidogrel 
Ticagrelor 
Prasugrel 
Statins 
Beta-blockers 
ACEI 
ARA-II 
Loop diuretics 
Thiazides 
Spirinolactone 
Insulin 
Oral hypoglycemic 
Anticoagulants 
Suspension P2Y12 Inhibitors Yes No 
Days of suspension of Inhibitors P2Y12 
__________________________________ 
Frail patient Yes No 
I use a fragility score Yes No 
Fragility score 
__________________________________ 
Other background 
__________________________________________ 
Presurgical data 
Presurgical diagnosis Heart failure 
Endocarditis 
Acute aortic syndrome 
Ischemic heart disease 
Valvular disease 
Pericardial involvement 
Other 
Related signs and symptoms Dyspnoea 
Precordial pain 
Edema in lower limbs 
Febrile syndrome 
Syncope 
Palpitations 
Neurological focus 
Acute Pulmonary Edema 
Tachyarrhythmias 
Bradyarrhythmias 
Other 
 
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(Select at least one) 
Coronary heart disease Yes 
No 
Left Coronary Trunk Injury Yes 

No 
Number of glasses 
__________________________________ 
Vessels affected Descending Anterior 
Diagonal 
Circumflex 
Lateroventricular 
Right Coronary 
Other 
Valvular disease Yes 
No 
Type of valve pathology Aortic stenosis 
Aortic insufficiency 
Mitral stenosis 
Mitral Insufficiency 
Pulmonary stenosis 
Pulmonary insufficiency 
Tricuspid stenosis 
Tricuspid Insufficiency 
(Select at least one) 
Combined Surgery Yes 
No 
(Valular + Bridges) 
Type of procedure Scheduled 
Urgency 
Emergency 
Laboratory upon admission 
Hematocrit ______ Leukocytes ______ Platelets ______ 
Blood glucose ______ Uremia ______ Creatinine ______ 
Cholesterol ______ HDL ______ LDL ______ 
Triglycerides ______ Total bile ______ GOT ______ 
GPT ______ 
Electrocardiogram 
Rhythm ______ Frequency ______ 
Prolonged PR ______ AV block ______ 
Right bundle branch block ______ Left bundle branch block ______ 
ST elevation ______ ST elevation ______ 
 
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T wave inversion ______ 
SCORES 
We ask you to complete the following values by calculating them. Click on the following links to 
enter the respective online calculators: 
EUROSCORE: https://www.rccc.eu/Cardio/euroscoreII.html 
ARGENSCORE: http://argenscore.org/calculadora.aspx 
EUROSCORE II mortality (%) ______ 
ARGENSCORE score ______ 
ARGENSCORE Mortality ______ 
Use of pre-surgical IACB Yes No 
Use of Swan Ganz presurgical Yes No 
Use of presurgical inotropics Yes No 
Intraoperative 
Date of surgery 
__________________________________ 
Patient condition Stable Unstable 
Use of ventricular assist Yes No 
Use of BCIAo Yes No 
Required transfusion of blood products Yes No 
Red blood cells 
__________________________________ 
(Units) 
Platelets 
__________________________________ 
(Units) 

Plasma 
__________________________________ 
(Units) 
Extracorporeal circulation Yes No 
CEC time 
__________________________________ 
(Minutes) 
Clamping time 
__________________________________ 
(Minutes) 
CRM was carried out Yes No 
Left breast bridge Yes No 
Right breast bridge Yes No 
Radial bridge Yes No 
Number of radial bridges 
__________________________________ 
 
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Venous bridge Yes No 
Number of venous bridges 
__________________________________ 
Endarterectomy Yes No 
Quality of the distal beds Good Regular 
Bad 
Valve surgery was performed Yes No 
Aortic valve plastic Yes No 
Aortica Jacoub plastic technique 
David 
Aortic valve replacement Yes No 
Type of Biological Aortic Valve with stent 
Biological without stent 
Single Disc Mechanics 
Clamshell Mechanics 
Biological valve type Aortic Pericardial 
Swine 
Bovine 
Aortic biological valve measurement 
__________________________________ 
(Number) 
Brand of Aortic Biological Valve 
__________________________________ 
Aortic mechanical valve measurement 
__________________________________ 
(Number) 
Aortica mechanical valve brand 
__________________________________ 
Ring enlargement Yes No 
Ring enlargement technique 
__________________________________ 
Plastic Mitral Valve Yes No 
Plastic was made on the previous valve 
Posterior leaflet 
Mitral valve replacement Yes No 
Biological Mitral Valve Type with Stent 
Biological without stent 
Single Disc Mechanics 
Clamshell Mechanics 
Type of Mitral Pericardial Biological Valve 
Swine 
 
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Bovine 

Mitral biological valve measurement 
__________________________________ 
(Number) 
Mitral Biological Valve Brand 
__________________________________ 
Mitral mechanical valve measurement 
__________________________________ 
(Number) 
Mitral mechanical valve brand 
__________________________________ 
Intra-operative TEE in mitral surgery Yes No 
Plastic Tricuspid Valve Yes No 
Tricuspid valve replacement Yes No 
Biological Tricuspid Valve Type 
Mechanics 
Tricuspid biological valve measurement 
__________________________________ 
(Number) 
Brand of Tricuspide Biological Valve 
__________________________________ 
Tricuspid mechanical valve measurement 
__________________________________ 
(Number) 
Tricuspid mechanical valve brand 
__________________________________ 
Pulmonary valve plastic Yes No 
Pulmonary valve replacement Yes No 
Biological Pulmonary Valve Type 
Mechanics 
Pulmonary biological valve measurement 
__________________________________ 
(Number) 
Pulmonary biological valve brand 
__________________________________ 
Pulmonary mechanical valve measurement 
__________________________________ 
(Number) 
Pulmonary mechanical valve brand 
__________________________________ 
Ross Surgery Yes No 
 
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Ascending Aortic Surgery Yes No 
Type of Ascending Aorta Surgery Bentall de Bono 
Resuspension 
WHEAT (supracoronary) 
Tirone David 
Yacoub 
Cabrol 
Tubular portion replacement 
Reattachment of supra-aortic vessels 
Other 
Aortic prosthesis placement Yes No 
Aortic prosthesis measurement 
__________________________________ 
(Number) 
Intra-surgical hemorrhage Yes No 
Cause of Medical Surgical Bleeding 
Intra-surgical arrest Yes No 
Readmission to CEC Yes No 
Other complications 
__________________________________________ 
Postoperative 
Via air Fast track (extubate) 

Intubated 
Extubates at <6 hours 
6 to 12 hours 
12 to 24 hours 
> 24 hours 
Long ARM Yes No 
ARM days 
__________________________________ 
Reintubation Yes No 
Hemorrhage Yes No 
(> 500 ml in the 1st hour or> 400 ml in the 2nd hour or 
> 300 ml in the 3rd hour or> 200 ml in the 4th hour or 
> 100 ml in the 5th hour) 
Type of Hemorrhage Medical Surgical 
Surgical examination required Yes No 
Surgical resolution Yes No 
Transfusion of blood products Yes No 
Right Ventricular Dysfunction Yes No 
(Persistent arterial hypotension, blood pressures 
 
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Elevated ventricular (right atrium) filling, 
low cost with need for intervention 
pharmacological and eventually mechanical (TAPSE <17 
mm or visual impression by Echocardiography of 
RV dysfunction)) 
Low expenditure syndrome Yes No 
(Systolic blood pressure <90 mmHg, pale and 
skin coldness, lack of capillary filling, 
clouding and oliguria, heart index 
<2.2 
L / min / m2, pulmonary capillary pressure> 18 mmHg, with 
inotropic and / or balloon requirement 
intra-aortic counterpulsation (IACAB)) 
Inotropic / vasopressor requirement Yes No 
Inotropics / Vasopressors used Dopamine 
Dobutamine 
Milrinone 
Levosinmendan 
Noradrenaline 
Vasopressin 
Adrenalin 
Swan Ganz requirement Yes No 
Perioperative myocardial infarction Yes No 
Definition of perioperative infarction according to the center Development of Q waves 
per ... Increased CPK MB â ‰ ¥ 80 IU / ml 
Parietal alterations on echocardiogram 
Troponin T or I> 10 times its baseline value 
US troponin> 10 times baseline 
Atrial fibrillation Yes No 
Atrioventricular block Yes No 
Complex ventricular arrhythmia Yes No 
Transient pacemaker Yes No 
Permanent pacemaker Yes No 
I do prophylaxis for postoperative AF Yes No 
Drug used 
__________________________________ 
POP day of initiation of prophylaxis for AF 
__________________________________ 
Renal failure Yes No 
(Increase in creatinine above 50% 
with respect to the baseline value and / or 
 

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hemodialysis) 
Hemodialysis Yes No 
Stroke Yes No 
(Focal and / or diffuse brain injury confirmed by 
clinical findings and / or computed tomography with 
sensory or motor sequelae upon discharge of the patient) 
Transient ischemic accident Yes No 
Psychiatric disorders Yes No 
(Any of the following: delirium, hallucinations, 
psychomotor arousal) 
Required treatment with ... Risperidone 
Quetiapine 
Haloperidol 
Other 
Respiratory distress syndrome Yes No 
(Infiltrate in 4 quadrants - PCP <18 - PAFI <200) 
Fever without obvious focus Yes No 
Sepsis Yes No 
(Suspected or documented infection with dysfunction of 
target organ and at least two of the following 
criteria: Temperature> 38 Â ° C or <36 Â ° C, 
White blood cell count greater than 12,000 uL or less 
at 4000 uL, Tachycardia, Tachypnea> 30 rpm, 
Altered mental state, Positive culture of 
primary focus of infection, mean arterial pressure 
less than 70 mm Hg for a minimum 
fingers 
hours, poor distal perfusionâ € ¨) 
Urinary infection Yes No 
Respiratory infection Yes No 
Surgical wound infection Yes No 
Superficial wound infection Yes No 
Saphenous wound infection Yes No 
Sternal infection Yes No 
Mediastinitis Yes No 
Sternal reopening requirement Yes No 
Sternal reopening POP day 
__________________________________ 
Sternal mechanical instability Yes No 
COVID-19 infection development during 
internment 
 
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If not 
TOTAL days of hospitalization until discharge 
__________________________________ 
POSTOPERATIVE days until discharge 
__________________________________ 
Discharge 
Alive 
Dead ______ 
Death cause: 
Infectious 
Cardiovascular 
Distributive shock 
Hemorrhage 
Cardiac tamponade 
Stroke 
Respiratory distress 
Multi-organ failure 
Another cause 
Death from infectious cause: Mediastinitis Pneumopathy Sepsis Other 

Identified germ 
__________________________________ 
Death from cardiovascular cause: Myocardial infarction Arrhythmia Heart failure 
Pre Registration Laboratory 
Hematocrit ______ Blood glucose ______ 
Uremia ______ Creatinine ______ 
Medication at discharge ASA 
Clopidogrel 
Ticagrelor 
Prasugrel 
Statins 
Beta-blockers 
Sartan 
ACE inhibitors 
Loop diuretic 
Thiazide 
Spironolactone 
Insulin 
Oral hypoglycemic 
Anticoagulants 
Investigator Notes 
__________________________________________ 
 
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Follow-up 
Re-internment Yes No 
(Within the first 30 days after discharge) 
Cause of re-admission: 
Heart failure 
Respiratory insufficiency 
Renal insufficiency 
Sepsis: 
Other 
Sepsis Yes: Sepsis starting point: Mediastinitis or other focus 
Another cause of re-admission 
__________________________________ 
Death no 
Death Yes: 
(Within the first 30 days after discharge) 
Cause of death in follow-up: Cardiovascular- NON-cardiovascular cause 
__________________________________