September/October 2014

A heart team working together during a TAVR procedure at Emory. The success of the heart team approach has has made it a model for care collaborations across cardiovascular care.

The FDA approved two types of devices for transcatheter aortic valve replacement (TAVR) after determining they were better than standard therapy for inoperable patients and an alternative to open surgery in high-risk patients. Nonetheless, this generally elderly patient population poses challenges and there are still potential missteps that could derail TAVR. Patient selection tools, 3D imaging and other approaches may minimize the likelihood of complications and poor outcomes occurring.

The U.S. trials for transcatheter aortic valve replacement (TAVR) are unusual in that they started with the sickest patients and then began working their way down the risk scale. 

The Centers for Medicare & Medicaid Services (CMS) will kick off its second round of Medicare penalties for 30-day readmissions soon, this time with CABG in its crosshairs.

Depending on whom you listen to, robotically assisted mitral valve repair is either still on the rise, already past its prime or currently plateauing as the very definition of a boutique medical procedure...

MedAxiom conducted a symposium June 18-20 in Beaver Creek, Colo., that offered pointers to directors, physicians and other professionals for improving the quality and efficiency of their cardiovascular service lines. Here are some of the lessons shared.

After the successful launch of “TCT Goes Tablet” at the Transcatheter Cardiovascular Therapeutics (TCT) conference in 2013, this year’s conference organizers have expanded their use of digital platforms.

Cardiovascular medical education programs feel increased pressure to incorporate simulation training in their curricula. 

Remote monitoring of implantable cardioverter-defibrillators (ICDs) and pacemakers shows marked improvement in patient outcomes, if only patients and providers would use it. 

It is no secret that peripheral artery disease (PAD) is a multidimensional disease affecting 8 to 12 million Americans—yet only 2 million even know they have it. 

Overall periprocedural death and stroke rates have declined in patients undergoing carotid artery stenting (CAS). 

Better documentation and billing practices are key to securing reimbursement, avoiding denials and protecting diminishing margins for catheterization laboratories. 

Given its etiologic role in atherogenesis, the management of risk related to low-density lipoprotein (LDL) has become a vital part of treating patients in danger of atherosclerotic cardiovascular disease (ASCVD). 

By participating on finance committees, cardiologists may guide hospital’s financial decisions rather than merely abide by them. Reginald J. Blaber, MD, a physician executive, pushes colleagues to dig into spreadsheets to find savings and opportunities to improve their cardiovascular service line.

An ambulance-based mobile stroke unit created by the University of Texas Health Science Center at Houston (UTHealth) Medical School and Memorial Hermann-Texas Medical Center (TMC). The vehicle has a small head CT scanner to enable imm edit imaging to confirm if a patient had a stroke and what type before they arrive at the hospital to enable faster door to repercussion times, or faster door to tPA administration times. The unit also has a telemedicine system so a neurologist can evaluate patients remotely.

Germany's ground-breaking use of CT scanners in ambulances to assess for possible stroke inspired one program in Houston to follow suit. Supporters predict it will transform care in the future. 

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