Cardiovascular Rounds

News, resources, and analysis from the Cardiovascular Roundtable

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Turn your cath lab into a well-oiled machine

November 15, 2013

Megan Tooley, Cardiovascular Roundtable

It’s no surprise that enhancing cath lab productivity is a hot topic. A number of market dynamics currently affect interventional procedures, from tighter margins and pressure to cut operating costs to the outpatient shift.

Progressive programs have developed some unique and effective approaches to improving efficiencies in the cath lab, and we’ve profiled them in The Highly-Productive CV Enterprise and Outmigration for CV Services. One such example is St. Elizabeth Medical Center, a 201-bed community hospital in Utica, New York.

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A Heart Team, in practice

September 26, 2013

Jeffrey Rakover, Cardiovascular Roundtable

The 2011 percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) guidelines include the “Heart Team” as a Class I recommendation for revascularization decision making in cases of complex coronary artery disease (CAD). In such cases, the optimal treatment strategy—PCI, CABG, or medical therapy—is often unclear. A Heart Team, including discussion by at least an interventional cardiologist and a cardiac surgeon, followed by shared decision making with the patient, offers the advantage of multiple expert perspectives and incorporation of patient preferences.

The Heart Team also can help reduce medical costs and improve appropriate use. The meetings offer a forum for formalized, expert review of a patient’s case compared to appropriate-use criteria (AUC), and shared decision making between patients and experts can promote the use of less-invasive, lower-cost therapies.

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St. Jude acquisition draws attention to emerging catheter ablation technology

August 28, 2013

Carly Anderson, Cardiovascular Roundtable

Last week, St. Jude Medical announced its purchase of Endosense, SA, a Swiss company that makes the TactiCath force-sensing cardiac ablation catheter system. This $170-million acquisition further expands St. Jude’s electrophysiology (EP) suite of offerings and brings increased attention to the evolution of catheter ablation technology—from single-point radiofrequency (RF) catheters to multi-electrode RF catheters, cyoablation technology, and force-sensing catheters like Endosense’s own TactiCath.

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How does your stent utilization compare? A Q&A with Brian Contos

August 22, 2013

Jeffrey Rakover, Cardiovascular Roundtable

Within interventional labs, provider decisions about stents continue to drive variable costs. Do you know how your institution’s utilization compares to that of your peers? National trends and emerging research can help you put utilization into perspective and identify savings opportunities, so I sat down with Brian Contos to discuss trends for two high-cost drivers: relative use of drug-eluting stents and the number of stents used per case.

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PCI: The next frontier in public readmissions reporting

August 5, 2013

Andrew Hresko, Cardiovascular Roundtable

Cardiovascular administrators are familiar with public reporting of readmissions rates for heart failure and acute myocardial infraction (AMI), but readmissions data for a new measure are now available. CMS recently partnered with the American College of Cardiology (ACC)’s National Cardiovascular Disease Registry (NCDR) to begin publishing readmissions rates for percutaneous coronary intervention (PCI).

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PCI bleeding avoidance strategies: Recent research developments

July 12, 2013

Jeffrey Rakover, Cardiovascular Roundtable

Many of our members have asked us recently about strategies for avoiding bleeding associated with percutaneous coronary intervention (PCI), and understandably so. Recent research has found that a major bleed is an even stronger predictor of post-PCI mortality than periprocedural myocardial infarction.

A number of risk-stratification strategies are available to identify PCI patients at high risk for bleeding, from Duke’s tool based on results of the CRUSADE study, to Columbia University’s online tool. Yet the best prophylaxis for high-risk patients is sometimes unclear.

Recent research has highlighted best practices in bleeding avoidance, underlining the roles of bivalirudin and radial PCI.

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TAVR highlights from ACC 2013

April 10, 2013

Megan Tooley, Cardiovascular Roundtable

For those of you who missed it, I wanted to share a recent blog post by our colleagues at the Advisory Board’s Technology Insights program, “TAVR Poised for Further Market Expansion,” which provides an overview of the latest research on transcatheter valves presented at the 2013 American College of Cardiology Scientific Sessions in San Francisco.

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Why the hype surrounding renal denervation?

January 30, 2013

Nicole MacMillan, Cardiovascular Roundtable 

Recently, a new treatment for drug-resistant hypertension known as renal denervation (RDN) has been a hot topic in the CV world. Also known as renal nerve ablation, the procedure has enormous potential to improve treatment for a large portion of the more than 68 million hypertensive patients in the United States, and may have a similarly dramatic impact for CV programs once it's approved by the FDA.

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Rating: | Brian Maher | March 30, 2012