SCAI expert consensus statement: 2016 best practices in the cardiac catheterization laboratory: (Endorsed by the cardiological society of india, and sociedad Latino Americana de Cardiologia intervencionista; Affirmation of value by the Canadian Association of interventional cardiology–Association canadienne de cardiologie d'intervention)*

Naidu, Srihari S.; Aronow, Herbert D.; Box, Lyndon C.; Duffy, Peter L.; Kolansky, Daniel M.; Kupfer, Joel M.; Latif, Faisal; Mulukutla, Suresh; Rao, Sunil V.; Swaminathan, Rajesh V.; Blankenship, James C.

doi:10.1002/ccd.26551

Cited by 82 publications

(55 citation statements)

References 76 publications

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“…5 The M&M process is led by the Director of Cardiovascular Medicine Performance Improvement (an interventional cardiologist) and the Administrative Director of the Cardiac Catheterization Laboratory. Administrative support (screening of cases, assembly of the case list, conference coordination, and 2…”

Section: Methodsmentioning

confidence: 99%

“…M&M conference is a common form of peer review used by percutaneous coronary intervention (PCI) programs and a potential method of accomplishing continuous quality improvement, ongoing professional practice evaluation, and case review. [1][2][3][4][5] Although the modern M&M conference dates from the mid-20th century and is familiar to most clinicians, 6 there is little consensus on strategies for effective case selection and review. 7 Previous description of M&M conference in the catheterization laboratory is limited to a single case report.…”

mentioning

confidence: 99%

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Morbidity and Mortality Conference for Percutaneous Coronary Intervention

Doll

Overton

Patel

et al. 2017

Circ: Cardiovascular Quality and Outcomes

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Background-Morbidity and mortality conference is a common educational and quality improvement activity performed in cardiac catheterization laboratories, but best practices for case selection and for maximizing the effectiveness of peer review have not been determined. Methods and Results-We reviewed the 10-year percutaneous coronary intervention morbidity and mortality conference experience of an academic medical center. Cases were triggered for review by the occurrence of prespecified procedural events. Summary reports from morbidity and mortality conference discussions were linked to clinical data from the Duke Databank for Cardiovascular Disease to compare baseline and procedural characteristics and to assess postdischarge outcomes. Of 11 786 procedures, from 2004 to 2013, 157 (1.3%) were triggered for review. The most frequent triggering events were cardioversion/defibrillation (72, 0.6%), unplanned use of mechanical circulatory support (64, 0.5%), and major dissection (41, 0.3%). Selected procedures were more likely to include high-risk features, such as ST-segmentelevation myocardial infarction, cardiogenic shock, and multivessel disease, and were associated with higher mortality at 30 days. Only a minority of triggering events were caused by controversial or unacceptable physician behavior. Conclusions-This 10-year experience outlines the processes for conduct of an effective percutaneous coronary intervention morbidity and mortality conference, including a novel approach to case selection and structured peer review leading to actionable quality interventions. The prespecified clinical triggers, captured in the natural workflow by laboratory staff, identified complex cases that were associated with poor patient outcomes. (Circ Cardiovasc Qual Outcomes.

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Section: Methodsmentioning

confidence: 99%

mentioning

confidence: 99%

Morbidity and Mortality Conference for Percutaneous Coronary Intervention

Doll

Overton

Patel

et al. 2017

Circ: Cardiovascular Quality and Outcomes

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“…Contrast‐induced acute kidney injury (CI‐AKI) is a common complication observed in patients undergoing invasive cardiac procedures and is associated with increased morbidity, mortality, and health care costs . Current professional society recommendations support identification of at risk patients, appropriate periprocedural hydration, and minimization of contrast volume in at‐risk patients as strategies to prevent CI‐AKI …”

Section: Introductionmentioning

confidence: 99%

Minimizing radiographic contrast administration during coronary angiography using a novel contrast reduction system: A multicenter observational study of the DyeVert™ plus contrast reduction system

Gurm

Mavromatis

Bertolet

et al. 2018

Cathet Cardio Intervent

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Objective To evaluate contrast media (CM) volume (CMV) saved using the DyeVert™ Plus Contrast Reduction System (DyeVert Plus System, Osprey Medical) in patients undergoing diagnostic coronary angiogram (CAG) and/or percutaneous coronary interventional (PCI) procedures performed with manual injections. Background Current guidelines advocate for monitoring and minimization of the total volume of CM in chronic kidney disease (CKD) patients undergoing invasive cardiac procedures. The DyeVert Plus System is an FDA cleared device designed to reduce CMV delivered during angiography and permit real‐time CMV monitoring. Methods We performed a multicenter, single‐arm, observational study. Eligible subjects were ≥ 18 years old with baseline estimated glomerular filtration rate (eGFR) 20–60 mL/min/1.73 m2. The primary endpoint was % CMV saved over the total procedure. A secondary objective was to evaluate adverse events (AEs) related to DyeVert Plus System or to CM use. Results A total of 114 subjects were enrolled at eight centers. Mean age was 72 ± 9 years, 72% were male, and mean body mass index was 29 ± 5. Baseline eGFR was 43 ± 11 mL/min/1.73 m2. CAG‐only was performed in 65% of cases. One hundred and five subjects were evaluable for the primary endpoint. Mean CMV attempted was 112 ± 85 mL (range 22–681) and mean CMV delivered was 67 ± 51 mL (range 12–403), resulting in an overall CMV savings of 40.1 ± 8.8% (95% CI 38.4, 41.8; P < 0.0001) per procedure. Image quality was maintained in all but one case where the system was turned off for one injection. No DyeVert Plus System‐related AEs were reported. Acute kidney injury (AKI; defined as serum creatinine rise of >0.3 mg/dL from baseline) was reported in 11 cases with seven occurring in subjects with baseline eGFR < 30 and three AKI events were attributed to CM. AKI rates increased as CMV/eGFR ratios increased. Conclusions These data suggest DyeVert Plus System use in CKD patients undergoing CAG and/or PCI results in clinically meaningful CMV savings while maintaining image quality.

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“…Use of low‐osmolar or iso‐osmolar contrast media, contrast volume minimization, and appropriate hydration are the only evidence‐based strategies that have been effective at reducing the incidence of CI‐AKI . Current professional society recommendations focus on identification of high‐risk patients, appropriate peri‐procedural hydration and minimization of contrast volume in high‐risk patients as strategies to prevent CI‐AKI . In previous work, our group and others have suggested a benefit of renal function‐based contrast media dosing with a contrast dose of less than three times the estimated creatinine clearance (CC) being associated with a low incidence of CI‐AKI .…”

Section: Introductionmentioning

confidence: 99%