Author + information
- Mohammed Salim Al-Damluji,
- Karl Minges,
- Jeffrey Bruckel,
- Brahmajee Nallamothu and
- Jeptha Curtis
Background: ACC/AHA guidelines recommend a multidisciplinary Heart Team approach in the management of patients with complex coronary artery disease (CAD). However, the adoption of Heart Teams in the US remains largely unknown.
Methods: We surveyed 500 hospitals (81% response rate) participating in the National Cardiovascular Data Registry – CathPCI Registry to assess PCI care processes, including the use of Heart Teams composed of a clinical cardiologist, cardiac surgeon, and interventional cardiologist.
Results: Of the responding hospitals, 215 (54%) reported using a Heart Team. To determine the optimal care for patients with complex CAD undergoing PCI, 168 (43%) of hospitals reported frequent use of risk prediction scores (e.g. SYNTAX, STS) and 280 (72%) regularly conferred with a cardiac surgeon. Interdisciplinary case conferences to discuss the best treatment strategy were regularly held in 183 (47%) hospitals. Compared to hospitals without a Heart Team, those with Heart Teams were more likely to report using procedural risk scores to guide treatment strategy, discuss PCI for complex CAD with a cardiac surgeon, or have regular interdisciplinary conferences (Figure).
Conclusions: In the US, the adoption of a Heart Team approach in complex CAD care occurred in just half of hospitals. PCI care processes differed greatly in the presence of Heart Teams. Further studies are needed to assess the relationship between the multidisciplinary Heart Team approach, appropriate PCI use, and patient outcomes.
Poster Hall, Hall C
Saturday, March 18, 2017, 3:45 p.m.-4:30 p.m.
Session Title: Interventional Cardiology: PCI and TAVR in Complex Patients
Abstract Category: 19. Interventional Cardiology: Complex Patients/Comorbidities
Presentation Number: 1239-119
- 2017 American College of Cardiology Foundation