An Overview of the Heart Surgery Specialty: heart transplant, lung transplant, heart-lung transplantation, aortic valve surgery, bypass surgery, minimally invasive cardiac surgery, heart valve surgery, removal of cardiac tumors, reoperation valve surgery
Reporter: Aviva Lev-Ari, PhD, RN
Updated on 2/17/2023
The training statement was developed in collaboration with and endorsed by the American Association for Thoracic Surgery, American Society of Echocardiography, Heart Failure Society of America, Heart Rhythm Society, Society of Cardiovascular Anesthesiologists, Society of Cardiovascular Computed Tomography, Society for Cardiovascular Magnetic Resonance, Society of Thoracic Surgeons, and Society for Vascular Medicine.
Interventional Cardiology Gets Codified Rules for Training
— Multi-society recommendations cover minimum procedural volumes, competencies
Professional societies laid out the roadmap to advanced training in interventional cardiology for the first time in a comprehensive statement of requirements.
The American College of Cardiology (ACC), American Heart Association, and Society for Cardiovascular Angiography and Interventions recommend a minimum 250 interventional procedures — including at least 200 percutaneous coronary interventions — during the 12-month interventional cardiology fellowship.
These groups also stipulate that at least 50 procedures should be a mix of coronary, peripheral vascular, and structural procedures. Another 25 procedures related to physiologic assessment and 25 related to intracoronary imaging are required during fellowship training as well, according to the multi-society writing group chaired by Theodore Bass, MD, of University of Florida Health Jacksonville.
The statement, published in the Journal of the American College of Cardiologyopens in a new tab or window, provides a full overview of training in interventional cardiology and elaborates on existing training requirements for this subspecialty from the ACC’s COCATS 4opens in a new tab or window, the Accreditation Council for Graduate Medical Educationopens in a new tab or window, and the American Board of Internal Medicineopens in a new tab or window.
“The document defines the required competencies for the full scope of interventional cardiology, providing trainees for the first time with the information to support training across all these areas,” Bass said in a press release.
Altogether, the training pathway for interventional cardiology should comprise several milestones of advancement across the COCATS 4 competencies:
- A 3-year general cardiovascular disease fellowship bringing the individual to Level I competency in all aspects of cardiovascular medicine and Level II competency in diagnostic cardiac catheterization to pursue interventional cardiology training
- A 1-year interventional cardiology fellowship bringing the individual to Level III competency in diagnostic and interventional cardiac catheterization
Notably, Bass and colleagues acknowledged that the 1-year fellowship focusing on coronary interventions will likely be insufficient for competency in other areas of interventional cardiology, hence the option of post-fellowship training for peripheral vascular or structural heart interventions during an unspecified period.
In this case, peripheral vascular training should include 100 diagnostic and 50 interventional peripheral artery interventions (half as primary operator), 25 carotid stents, 20 endovascular aortic aneurysm repairs, and 20 peripheral venous interventions.
Structural heart training requires 50 transcatheter aortic valve replacements (25 as primary operator), various structural heart procedures, and adult congenital heart disease interventions.
Bass and colleagues also recommended that trainees get experience working with cardiac surgeons and cardiologists who have advanced training in electrophysiology, cardiac imaging, heart failure, and advanced practice providers, as well as with relevant multispecialty teams.
After initial training, certified interventional cardiologists are responsible for lifelong learning to ensure continued maintenance of certification and competence throughout their careers.
Primary SOURCE
Journal of the American College of Cardiology
Source Reference: opens in a new tab or window
Bass TA, et al “2023 ACC/AHA/SCAI advanced training statement on interventional cardiology (coronary, peripheral vascular, and structural heart interventions): A report of the ACC Competency Management Committee” J Am Coll Cardiol 2023; DOI: 10.1016/j.jacc.2022.11.002.
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Heart Transplant Surgeons at Cleveland Clinic:
http://my.clevelandclinic.org/transplant/services/heart/team.aspx
Cleveland Clinic: Change at the Top, Tomislav “Tom” Mihaljevic, M.D., as its next CEO and President to succeed Toby Cosgrove, M.D., effective Jan. 1, 2018
Treatment & Services
- Aorta Graft
- Aorta Surgery
- Aortic Dissection
- Aortic Valve Repair
- Aortic Valve Replacement
- Aortic Valve Surgery
- Arterial Coronary Artery Bypass Grafts
- Atherosclerosis Surgery
- Atrial Septal Defect Closure
- Bypass Surgery
- Cardiac Surgery
- Complex Aorta Surgery
- Coronary Artery Reoperation
- Epicardial Lead Placement
- Heart Failure Surgery
- Heart Surgery
- Heart Surgery for Marfan Syndrome
- Heart Surgery Reoperation
- Heart Valve Surgery
- High Risk Reoperation Surgery
- Left Ventricular Reconstructive Surgery
- Lung Transplantation
- Minimally Invasive Aortic Valve Repair
- Minimally Invasive Cardiac Surgery
- Minimally Invasive Heart Surgery
- Minimally Invasive Mitral Valve Repair
- Minimally Invasive Surgery
- Mitral Valve Replacement
- Mitral Valve Surgery
- Myectomy
- Myocardial Biopsy
- Off Pump Bypass Surgery
- Organ Transplantation
- Pericardiectomy
- Pericardiocentesis
- Pericardium Surgery
- Pulmonary Embolism Surgery
- Pulmonary Vein Ablation Procedure
- Radial Artery and Saphenous Vein Harvesting
- Removal of Atrial Myxoma
- Removal of Cardiac Tumors
- Reoperation Valve Surgery
- Surgery for Thoracic Aortic Aneurysm
- Surgical Ablation Of Atrial Fibrillation
- Valve Surgery
Specialty in Diseases and Conditions
- Aneurysms
- Aorta Disease
- Aortic Aneurysms
- Aortic Regurgitation
- Aortic Stenosis
- Atherosclerosis (vascular)
- Atrial Fibrillation
- Atrial Septal Defects
- Cardiac Tumors
- Cardiomyopathy
- Coarctation Of The Aorta
- Congenital Heart Disease
- Congenital Valve Disease
- Constrictive Peridarditis
- Coronary Artery Disease
- Cystic Fibrosis
- Dilated Cardiomyopathy
- Endocarditis
- Heart Disease
- Heart Failure
- Heart Valve Disease
- Heart Valve Infections
- Hypertrophic Cardiomyopathy
- Infective Endocarditis
- Ischemic Cardiomyopathy
- Marfan Syndrome
- Mitral Valve Prolapse
- Mitral Valve Regurgitation
- Mitral Valve Stenosis
- Myxomas
- Patent Foramen Ovale
- Pericarditis
- Pulmonary Valve Disease
- Pulmonic Regurgitation
- Pulmonic Stenosis
- Restrictive Cardiomyopathy
- Rheumatic Heart Disease
- Thoracic Aortic Aneurysm
- Tricuspid Regurgitation
- Tricuspid Stenosis
- Tricuspid Valve Disease
One heart in 3 patients.
Source
Heart and Vascular Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates.
Abstract
In this report, we present a successful reuse of a transplanted heart under complex clinical conditions. Our patient was the second recipient, a 63-year-old man with end-stage heart failure due to amyloid-induced cardiomyopathy. After an uneventful postoperative course, he was diagnosed with acute myelogenous leukemia 6 months after transplantation and died 10 months after transplantation. This outcome was determined by a malignancy in an immunosuppressed patient. Reuse of a transplanted heart in carefully selected patients is a possible alternative in an era of donor organ shortage.
Copyright © 2012 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.
- PMID: 23176956
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