Algorithm For MCS Decision-Making Members of ACC’s Interventional Section have created an algorithm to guide interventional cardiologists in clinical decision-making related to mechanical circulatory support (MCS) devices in patients undergoing percutaneous coronary intervention with high-risk features or cardiogenic shock. The statement, published May 2 in JACC: Cardiovascular Interventions, defines a practical approach for the interventional cardiologist regarding when to use MCS, how to select a device type, and practical points to consider when utilizing these devices. Should PCI Outcomes For Cardiac Arrest or Cardiogenic Shock be Publically Reported? Public reporting of percutaneous coronary intervention (PCI) outcomes in patients with cardiac arrest or cardiogenic shock may be unfair to interventionalists and may lead to worse outcomes, according to a council perspective published March 7 in JACC: Cardiovascular Interventions. Syed Tanveer Rab, MD, FACC, member of ACC’s Interventional Section Leadership Council, and B. Hadley Wilson, MD, FACC, president of the ACC North Carolina Chapter, write that public reporting of death after PCI places blame on the hospital or interventionalists, but mortality is usually the result of neurological complications or multi-organ failure despite receiving optimal care. Additionally, they are concerned that public reporting and “pay for performance” may lead to risk-adverse behavior that may in turn lead to negative consequences for patients. Anticoagulation For Acute PE Anticoagulation should be the preferred method for treating patients with acute pulmonary embolism (PE), with more invasive treatment reserved for those at higher risk, according to a council perspective published Feb. 22 in the Journal of the American College of Cardiology. Most patients with massive and submassive PE continue to be treated with only anticoagulation, despite high fatality rates. Because of the difficulty of treating PE patients, hospitals have formed multidisciplinary pulmonary embolism response teams (PERTs) to discuss treatment options and provide therapy for these patients. The Council recommends that, at a minimum, a PERT should include representatives from medicine, interventional cardiology/radiology and surgery. Learn more about the Interventional Section at ACC.org/InterventionalSection. Stay up-to-date on the latest news and science in interventional cardiology by visiting the Invasive Cardiovascular Angiography and Intervention Clinical Topic Collection on ACC.org.
Published by American College of Cardiology. View All Articles.