Jeffrey J. Cavendish

2012 American College of Cardiology Foundation/Society for Cardiovascular Angiography and Interventions Expert Consensus Document on Cardiac Catheterization Laboratory Standards update: A report of the American College of Cardiology Foundation Task Force on Expert Consensus Documents

published online May 8, 2012; J. Am. Coll. Cardiol. L. Tommaso Carl Moliterno, John W.M. Moore, Sandra M. Oliver-McNeil, Jeffrey J. Popma, and Landzberg, Warren K. Laskey, Charles R. McKay, Julie M. Miller, David J. Cavendish, Charles E. Chambers, James Bernard Hermiller, Jr, Scott Kinlay, Joel S. M. Bashore, MD, FACC,, Stephen Balter, Ana Barac, John G. Byrne, Jeffrey J. Documents, Society of Thoracic Surgeons, Society for Vascular Medicine, Thomas American College of Cardiology Foundation Task Force on Expert Consensus Catheterization Laboratory Standards Update Angiography and Interventions Expert Consensus Document on Cardiac 2012 American College of Cardiology Foundation/Society for Cardiovascular This information is current as of May 25, 2012 http://content.onlinejacc.org/cgi/content/full/j.jacc.2012.02.010v1 located on the World Wide Web at: The online version of this article, along with updated information and services, is

2012 American College of Cardiology Foundation/Society for Cardiovascular Angiography and Interventions expert consensus document on cardiac catheterization laboratory standards update: A report of the American College of Cardiology Foundation Task Force on Expert Consensus documents developed in collaboration with the Society of Thoracic Surgeons and Society for Vascular Medicine.

published online May 8, 2012; J. Am. Coll. Cardiol. L. Tommaso Carl Moliterno, John W.M. Moore, Sandra M. Oliver-McNeil, Jeffrey J. Popma, and Landzberg, Warren K. Laskey, Charles R. McKay, Julie M. Miller, David J. Cavendish, Charles E. Chambers, James Bernard Hermiller, Jr, Scott Kinlay, Joel S. M. Bashore, MD, FACC,, Stephen Balter, Ana Barac, John G. Byrne, Jeffrey J. Documents, Society of Thoracic Surgeons, Society for Vascular Medicine, Thomas American College of Cardiology Foundation Task Force on Expert Consensus Catheterization Laboratory Standards Update Angiography and Interventions Expert Consensus Document on Cardiac 2012 American College of Cardiology Foundation/Society for Cardiovascular This information is current as of May 25, 2012 http://content.onlinejacc.org/cgi/content/full/j.jacc.2012.02.010v1 located on the World Wide Web at: The online version of this article, along with updated information and services, is

Clinical expert consensus statement on best practices in the cardiac catheterization laboratory: Society for cardiovascular angiography and interventions

The cardiac catheterization laboratory (CCL) is a setting in which elective, urgent, and emergent percutaneous procedures are performed. This poses challenges to maintaining and prioritizing high quality care and patient safety. Nonetheless, process expectations of a high-quality CCL include appropriate periprocedural communication, clinical management, documentation, and universal protocol. Regulations primarily targeted at open surgical operating rooms have the potential to negatively impact care because they may mandate focus on performance measures that are not necessarily relevant to the cardiac catheterization laboratory. For example, routine site marking for percutaneous access is irrelevant for most patients since failure to obtain access on one side (e.g., right femoral artery) simply leads to attempting access on the other side (e.g., left femoral artery). Instead, directives should be tailored to the percutaneous procedure setting to assure quality and optimal patient safety. This document will therefore provide expert consensus opinion on a number of issues pertaining to ‘‘best practices’’ within the CCL, focusing on quality and safety during each step of the process. The writing committee acknowledges a dearth in high-quality published studies in this area, making many of the enclosed recommendations based primarily on expert consensus. Although references are provided when available, further research specifically in catheterization laboratory processes and quality improvement is needed. The document is divided into ‘‘best practices’’ that should be performed during the preprocedure, intraprocedure, and postprocedure settings for diagnostic cardiac catheterization and coronary intervention, to be consistent with the typical patient flow into and out of the CCL. Despite the long history of cardiac catheterization that dates back several decades, a document describing these ‘‘best practices’’ has not yet been written. The purpose of this document is not to represent all acceptable practices, but to provide consensus opinion on what would currently be considered ‘‘best practices’’ as future goals for catheterization laboratories.

A pilot study: reports of benefits from a 6-month, multidisciplinary, shared medical appointment approach for heart failure patients.

ABSTRACT Heart failure continues to be the leading cause of hospitalization among older adults. Noncompliance with medications, dietary indiscretion, failure to recognize symptoms, and failed social support systems contribute to increased morbidity. Multidisciplinary medical approaches have proven successful for heart failure. In 2004, the Naval Medical Center San Diego started a multidisciplinary shared medical appointment for patients with complicated cases of heart failure. Patients enrolled in the heart failure clinic were monitored prospectively for 6 months. Validated questionnaires concerning satisfaction with care, self-care management, depression, and quality-of-life measures were administered at baseline and 6 months after enrollment. Thirty-nine individuals were enrolled in the clinic, with 33 completing 6 months of follow-up monitoring to date. Hospital admissions for any cause decreased from 11 to eight, whereas congestive heart failure-related admissions decreased from four to two. There was...ABSTRACT Heart failure continues to be the leading cause of hospitalization among older adults. Noncompliance with medications, dietary indiscretion, failure to recognize symptoms, and failed social support systems contribute to increased morbidity. Multidisciplinary medical approaches have proven successful for heart failure. In 2004, the Naval Medical Center San Diego started a multidisciplinary shared medical appointment for patients with complicated cases of heart failure. Patients enrolled in the heart failure clinic were monitored prospectively for 6 months. Validated questionnaires concerning satisfaction with care, self-care management, depression, and quality-of-life measures were administered at baseline and 6 months after enrollment. Thirty-nine individuals were enrolled in the clinic, with 33 completing 6 months of follow-up monitoring to date. Hospital admissions for any cause decreased from 11 to eight, whereas congestive heart failure-related admissions decreased from four to two. There was a total of six deaths. During the 6 months of enrollment, use of angiotensin-converting enzyme inhibitors and beta-receptor blockers had absolute increases of 20% and 19%, respectively. Statistically significant improvements were seen in the Beck Depression Inventory and Self-Care Management Index results. A multidisciplinary approach to heart failure patients using the shared medical appointment model can improve patient satisfaction, enhance quality of life, and help reduce hospitalizations while improving provider efficiency.

2012 American College of Cardiology Foundation/ Society for Cardiovascular Angiography and Interventions Expert Consensus Document on Cardiac Catheterization Laboratory Standards Update

published online May 8, 2012; J. Am. Coll. Cardiol. L. Tommaso Carl Moliterno, John W.M. Moore, Sandra M. Oliver-McNeil, Jeffrey J. Popma, and Landzberg, Warren K. Laskey, Charles R. McKay, Julie M. Miller, David J. Cavendish, Charles E. Chambers, James Bernard Hermiller, Jr, Scott Kinlay, Joel S. M. Bashore, MD, FACC,, Stephen Balter, Ana Barac, John G. Byrne, Jeffrey J. Documents, Society of Thoracic Surgeons, Society for Vascular Medicine, Thomas American College of Cardiology Foundation Task Force on Expert Consensus Catheterization Laboratory Standards Update Angiography and Interventions Expert Consensus Document on Cardiac 2012 American College of Cardiology Foundation/Society for Cardiovascular This information is current as of May 25, 2012 http://content.onlinejacc.org/cgi/content/full/j.jacc.2012.02.010v1 located on the World Wide Web at: The online version of this article, along with updated information and services, is

Concomitant coronary and multiple arch vessel stenoses in patients treated with external beam radiation: Pathophysiological basis and endovascular treatment

External beam radiation‐induced stenoses isolated to the coronary arteries or peripheral vessels have been previously described. We report for the first time the clinical presentation of two patients with concomitant coronary artery and multiple arch vessel disease following external beam radiation of the chest. We review the pathophysiology, discuss the treatment options and describe the percutaneous treatment of coronary, carotid, subclavian, and axillary stenoses related to this rare but likely underdiagnosed disorder. Catheter Cardiovasc Interv 2004;62:385–390.

Recent advances in hemodynamics: noncoronary applications of a pressure sensor angioplasty guidewire.

The use of the pressure sensor coronary guidewire is expanding into the peripheral circulation as well as into the realm of valvular heart disease. Small mechanistic studies and case reports have described the use of pressure wire technology in the renal and femoral arteries as well as in mechanical aortic valves. The use of this technology to measure hemodynamically significant stenoses in noncoronary locations will be discussed and a review of basic and more advanced hemodynamics in relation to problems encountered in clinical practice will be provided.

Role of antiplatelet therapy in cardiovascular disease I: Acute coronary syndromes.

The acute coronary syndromes (ACS), consisting of ST-segment elevation myocardial infarction (STEMI), non-STEMI (NSTEMI), and unstable angina, remain a leading cause of death in the United States. Through the process of atherothrombosis, underlying atherosclerosis can progress to an acute ischemic coronary event. This disease mechanism is also common to ischemic stroke and peripheral arterial disease. As ACS is a heterogeneous disease, accurate patient diagnosis and risk categorization is essential. Treatment approaches for both STEMI and NSTEMI ACS consist of a combination of surgical intervention and pharmacotherapy, with antiplatelet agents such as clopidogrel, aspirin and glycoprotein IIb/IIIa receptor antagonists playing an essential role.

Role of antiplatelet therapy in cardiovascular disease III: Peripheral arterial disease.

SUMMARY Peripheral arterial disease (PAD) is a common manifestation of the atherosclerotic disease process, typically affecting vascular beds in the lower extremities. In its most severe form PAD may lead to limb amputation. Patients with PAD are also at increased cross-risk of thrombosis at coronary and cerebrovascular sites. However, despite its prevalence and severity, PAD is underdiagnosed and undertreated. In this collection of case studies, the role of the antiplatelet agent clopidogrel in current treatment strategies for the management of PAD is highlighted.

2012 American college of cardiology foundation/society for cardiovascular angiography and interventions expert consensus document on cardiac catheterization laboratory standards update: American college of cardiology foundation task force on expert consensus documents society of thoracic surgeons society for vascular medicine

WRITING COMMITTEE MEMBERS* Thomas M. Bashore, MD, FACC, FSCAI, chair, Stephen Balter, PhD, FAAPM, FACR, FSIR, Ana Barac, MD, PhD, John G. Byrne, MD, FACC, Jeffrey J. Cavendish, MD, FACC, FSCAI, Charles E. Chambers, MD, FACC, FSCAI, James Bernard Hermiller, Jr, MD, FACC, FSCAI, Scott Kinlay, MBBS, PhD, FACC, FSCAI, Joel S. Landzberg, MD, FACCk, Warren K. Laskey, MD, MPH, FACC, FSCAI, Charles R. McKay, MD, FACC, Julie M. Miller, MD, FACC, David J. Moliterno, MD, FACC, FSCAI, John W.M. Moore, MD, MPH, FACC, FSCAI, Sandra M. Oliver-McNeil, DNP, ACNP-BC, AACC, Jeffrey J. Popma, MD, FACC, FSCAI, and Carl L. Tommaso, MD, FACC, FSCAI