Cardiovascular Rounds

News, resources, and analysis from the Cardiovascular Roundtable

Filtered by: Cardiac Cath Hide

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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How can CV programs optimize cath lab scheduling to match demand and lower costs?

January 17, 2013

Jeffrey Rakover, Cardiovascular Roundtable

The Roundtable has received a number of questions recently regarding cath lab scheduling given today’s unpredictable volumes. We have identified several scheduling strategies that can reap rewards both in enhanced efficiency and reduced costs, addressing concerns ranging from decreasing volumes to excessive overtime costs and staff morale.  

While our research finds no scheduling approach fits every institution, some promising practices are worth considering such as flexing labs and staggering staff shifts.

Below, you will find links to additional resources touching on numerous other scheduling questions — from whether to implement block scheduling to how best to delegate scheduling responsibility.


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So you're not a TAVR program—Now what?

January 14, 2013

Megan Tooley, Cardiovascular Roundtable

There is no question the emergence of transcatheter valve technologies—specifically transcatheter aortic valve replacement (TAVR)—has elicited unprecedented excitement from the cardiovascular community in recent years. However, despite this enthusiasm, the reality is only a portion of hospitals will meet the strict resource and volume requirements necessary to become TAVR sites in the near future.

This may leave many of you wondering, “So what if we’re not a TAVR program? Is there still a place for us in the valve market?” You’re not alone, and as we explore in our national meeting series, your options for treating valve disease and disorders do not end at TAVR.

Learn how one Roundtable member is ensuring their patients have access to a full range of valve services—even if they’re not the TAVR program.

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Informed consent for cardiovascular procedures: Resources for your program

January 10, 2013

Nicole MacMillan, Cardiovascular Roundtable

With the recent release of the Society for Cardiovascular Angiography and Interventions’ (SCAI) consensus statement on ad hoc PCI, the discussion around informed consent for cardiac procedures has again risen to the forefront of our members’ topics of interest.

One study we discussed previously suggests that patient education surrounding elective PCI decisions is often infrequent and ripe for improvement. This dialogue with patients will become increasingly critical as providers seek to activate patients in their care to secure both loyalty and engagement throughout the treatment process.

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SYNTAX trial confirms surgery best for most patients

November 1, 2012

Final results of the five-year SYNTAX trial find CABG surgery delivers better outcomes than PCI for intermediate-high risk patients.

This trend was surprisingly apparent for patients with three-vessel disease and at high risk for surgical complication. However, patients who underwent CABG or PCI that had left main disease with fewer than three vessels affected had equivalent rates of major adverse cardiac and cerebrovascular events (MACCE).

Nevertheless, researchers note that nearly 80% of patients with three-vessel disease have a 79% improved survival rate with surgery over PCI. These results suggest that for high-risk patients, surgery may be the best treatment pathway, demonstrating fewer downstream complications.

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