Modern cardiac catheterization laboratories bear scant resemblance to the cath labs of a decade ago. An updated consensus statement released today offers physicians guidance on how to excel in this new diagnostic and therapeutic milieu, with specific recommendations on setting up, operating and maintaining the highest standards of quality in a contemporary cardiac catheterization laboratory.
The consensus statement was developed by an expert panel of the American College of Cardiology Foundation (ACCF) and the Society for Cardiovascular Angiography and Interventions (SCAI), in collaboration with the Society of Thoracic Surgeons and the Society for Vascular Medicine. It updates a similar document released in 2001.
"There have been a lot of changes since 2001, some of them dramatic," said Thomas M. Bashore, MD, writing committee chair and professor of medicine and clinical chief of cardiology at Duke University Medical Center, Durham, NC. "This document sets the stage for what's really happening in cath labs today and updates everyone on accepted quality standards and best practices."
Among the changes has been a shift in focus from diagnostic tests to catheter-based therapies, from coronary disease alone to include the treatment of valvular heart disease, congenital defects of the heart and arterial disease in the legs, brain, and other organs. An increasing number of medical centers are developing hybrid cath labs that combine all the features of a surgical suite with those of a cath lab. And pediatric cath labs—now devoted almost exclusively to therapy—apply minimally invasive catheter techniques to congenital disease that once required major heart surgery, with procedures now being performed on unborn fetuses and newborns, as well as older children.
The new consensus statement addresses the features of modern cath labs, including:
Consensus documents serve many purposes, but the most important is to define high-quality clinical practice, Dr. Bashore said.
"We don't always have randomized clinical trials to rely on," he said. "The purpose of this document is to define a practice standard for how you set up and run a cath lab, the people in the cath lab, the quality assurance programs—all the things cath lab teams should be thinking about."
The document can be accessed at www.cardiosource.org and www.SCAI.org . It will also be published in the June 5, 2012, issue of the Journal of the American College of Cardiology and in a forthcoming issue of Catheterization and Cardiovascular Interventions.
The American College of Cardiology Foundation is transforming cardiovascular care and improving heart health through continuous quality improvement, patient-centered care, payment innovation and professionalism. The College is a 40,000-member nonprofit medical society comprised of physicians, surgeons, nurses, physician assistants, pharmacists and practice managers and bestows credentials among cardiovascular specialists who meet its stringent qualifications. The College is a leader in the formulation of health policy, standards and guidelines, and is a staunch supporter of cardiovascular research. The ACC provides professional education and operates national registries for the measurement and improvement of quality care. More information about the association is available online at http://cardiosource.org/ACC .
The Society for Cardiovascular Angiography and Interventions is a 4,000-member professional organization representing invasive and interventional cardiologists in more than 60 nations. SCAI's mission is to promote excellence in invasive and interventional cardiovascular medicine through physician education and representation, and advancement of quality standards to enhance patient care. SCAI's patient and physician education program, Seconds Count, offers comprehensive information about cardiovascular disease. For more information about SCAI and Seconds Count, visit www.scai.org or www.secondscount.org .
Journal of the American College of Cardiology