- It is estimated that more than 125 million people live with ischemic heart disease globally, and each year in the United States, 720,000 have a first myocardial infarction resulting in hospital admission or death.1,2 Approximately 35% of those who experience a coronary event in a given year die because of it, and each death is associated with an average of 16 years of life lost. Ischemic cardiomyopathy (ICM) is the single largest cause of heart failure (HF), although the underlying causes are often multifactorial and overlapping.
- Acute aortic dissection (AD) involves the ascending aorta in approximately two-thirds of patients.1,2 Chest pain is the most common feature, but clinical presentation can be varied, and algorithms have been developed to facilitate timely diagnosis.3,4 Nevertheless, delays in diagnosis comes at a severe cost to the patient.5 The complications of AD that involve the ascending aorta have been known for well over 60 years and include aortic rupture, cardiac tamponade, aortic regurgitation (AR), and organ malperfusion.
- Bicuspid aortic valve disease is the most common congenital cardiac disorder, being present in 1% to 2% of the general population. Associated aortopathy is a common finding in patients with bicuspid aortic valve disease, with thoracic aortic dilation noted in approximately 40% of patients in referral centers. Several previous consensus statements and guidelines have addressed the management of bicuspid aortic valve–associated aortopathy, but none focused entirely on this disease process. The current guidelines cover all major aspects of bicuspid aortic valve aortopathy, including natural history, phenotypic expression, histology and molecular pathomechanisms, imaging, indications for surgery, surveillance, and follow-up, and recommendations for future research.
- With the evolution of transcatheter valve replacement, an important opportunity has arisen for cardiologists and surgeons to collaborate in identifying the criteria for performing these procedures. Therefore, The Society for Cardiovascular Angiography and Interventions (SCAI), American Association for Thoracic Surgery (AATS), American College of Cardiology (ACC), and The Society of Thoracic Surgeons (STS) have partnered to provide recommendations for institutions to assess their potential for instituting and/or maintaining a transcatheter valve program.
- The granting of staff privileges to physicians is an important mechanism to ensure quality care. The Joint Commission requires that medical staff privileges be based on professional criteria specified in medical staff bylaws. Physicians are charged with defining the criteria that constitute professional competence and with evaluating their peers accordingly. With the evolution of transcatheter valve therapy, an important opportunity arises for both cardiologists and surgeons to come together to identify the criteria for performing these procedures.
- Transcatheter aortic valve replacement (TAVR) has transformed the care of patients with aortic stenosis. The dissemination of this technology after its approval in the United States in the wake of a pivotal randomized trial1,2 has thus far proceeded in a thoughtful and circumspect manner, guided by a coalition of stakeholders dedicated to the delivery of high-quality, patient-centered care. It is anticipated that a number of transcatheter therapies for mitral regurgitation (MR) will also become available for clinical use in selected patients.
- The granting of staff privileges to physicians is an important mechanism to ensure quality care. The Joint Commission on Accreditation of Healthcare Organizations requires that medical staff privileges be based on professional criteria specified in medical staff bylaws. Physicians are charged with defining the criteria that constitute professional competence and with evaluating their peers accordingly. With the evolution of transcatheter aortic valve replacement (TAVR), an important opportunity arises for both cardiologists and surgeons to come together to identify the criteria for performing these procedures.