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Equipes especiais para procedimentos especiais

por Loren Bonner, DOTmed News Online Editor | April 17, 2012
Philips FlexMove positioning system
From the April 2012 issue of HealthCare Business News magazine

The traditional cath angio room is making way for a crowd of professionals.

On any given day at top heart centers around the country, a cardiac surgeon, an interventional cardiologist, an interventional radiologist as well as an electrophysiologist will come together to perform a heart procedure in a cath angio lab. These teams of heart specialists routinely perform procedures using a catheter inserted through a patient’s arm or leg to treat complex cases of artery disease and arrhythmias.

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“A patient may have five cardiac specialists working together to provide unified, comprehensive cardiac care,” says Dr. Peter Weiss, an electrophysiologist at Intermountain Heart Rhythm Specialists, part of Intermountain Medical Center in Salt Lake City, Utah.

The multidisciplinary team is one sign that dedicated cath angio labs are a thing of the past.

“Some of the procedures that were typically done as open surgical procedures are becoming less invasive,” says Rob Dewey, senior director of cardiology and hybrid OR for the angiography division at Siemens Healthcare. “As a result, the surgeons experienced with open surgical procedures now work side by side with their interventional colleagues experienced with catheter-based approaches.”

In many large U.S. hospitals, this team approach has been common practice for years. But only recently have some of the societies that govern these specialties made significant efforts to promote it. The American College of Cardiology Foundation, American Heart Association and Society for Cardiovascular Angiography and Interventions included a heart team approach in revised percutaneous coronary intervention guidelines for 2011. The recommendation was placed in the class I category—the highest rank—for patients with unprotected left main or complex coronary artery disease. In other words, there’s now a scoring system or defined set of rules to help with the decision.

“This heart team is a way to use the syntax to determine which patients might do better with one form of revascularization or another,” says Dr. Jeffrey Marshall, president-elect for SCAI.

Before cardiologists, interventional cardiologists and cardiothoracic surgeons find themselves together in a lab, these new guidelines urge them to jointly review a patient’s condition, evaluate the pros and cons of each treatment, and present the options to the patient, along with their recommendation.

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