Our mission is to become a worldwide reference for education in the field for all professionals involved in the process to disseminate knowledge & skills of Acute Cardiovascular Care.
Our mission is to promote excellence in clinical diagnosis, research, technical development, and education in cardiovascular imaging in Europe.
Our mission is to promote excellence in research, practice, education and policy in cardiovascular health, primary and secondary prevention.
Our mission is to reduce the burden of cardiovascular disease through percutaneous cardiovascular interventions.
Improving the quality of life and reducing sudden cardiac death by limiting the impact of heart rhythm disturbances.
Our mission is to improve quality of life and longevity, through better prevention, diagnosis and treatment of heart failure, including the establishment of networks for its management, education and research.
The ESC Working Groups' goal is to stimulate and disseminate scientific knowledge in different fields of cardiology.
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OUR MISSION: TO REDUCE THE BURDEN OF CARDIOVASCULAR DISEASE
A symposium will today explore the interaction between cardiologists and cardiac surgeons on heart teams - and highlight the need for improvement.
Multidisciplinary team-working in cardiology is already widely adopted in TAVI, revascularisation and HF. Now well established in oncology, this heart team approach involves specialists - including surgeons, consultants, nurses and anaesthetists - sharing knowledge and expertise on the best way forward for patients without an obvious treatment pathway.
Surgeons on TAVI and revascularisation teams will be involved throughout. However, adult intensive care specialist Susanna Price says this is not the case with HF teams where surgeons are only visible at the initial and end stages. This mind-set, however, needs to change, says Price, a consultant cardiologist and intensivist at the Royal Brompton and Harefield NHS Foundation Trust in London. ‘I’m concerned that this is far removed from what a multidisciplinary team should be,’ she adds. ‘We’re missing a trick because it’s the surgeons who are developing all these new therapies based on robotics and extracorporeal circuits. They’re very innovative but don’t have a role [on HF teams] - it’s a missed opportunity.’
In addition, Price believes that surgeons are vital in specialist teams set up to treat cardiogenic shock. Apart from in isolated centres, she says, ‘very little’ is being done to improve mortality rates for this condition, which are currently around 50%. They could be reversed though if institutions deployed ‘shock’ teams dedicated to delivering early intervention to patients - for example, extracorporeal membrane oxygenation (ECMO). These teams would bring together cardiac surgeons, interventional cardiologists, perfusionists, imaging specialists, cardiac anaesthetists as well as nurses. Says Price: ’It would be like having a cardiac arrest team but with an added surgeon and identifying patients immediately. The 2015 resuscitation guidelines acknowledged that ECMO might be used in cardiopulmonary resuscitation, so using ECMO earlier could become a thing of the future.’
The degree of co-operation between cardiologists and surgeons is an issue too in the interventional treatment of valvular disease. Hendrik Treede will acknowledge in today’s Symposium that TAVI has become the perfect example of successful collaboration between cardiologists, cardiac surgeons and imaging specialists. However, he will also highlight how the extent of collaboration varies, not only between centres but also between countries.
‘In many countries interventional treatment of heart valve disease is often in the hands of cardiologists alone and surgeons are not involved,’ says Treede from the Comprehensive Heart Center, University Hospital Halle, Germany. ‘The consequence is that indications and treatments are no longer discussed, choice of access routes is limited and additional risks may be taken.’
In some centres, a situation even exists where two TAVI teams work in parallel. The impact is that they are not profiting from the wealth of skills which exists among the respective specialists. Treede believes an ‘everybody does everything’ policy is necessary to improve the interaction between cardiologists and surgeons. His vision is for them to be cross trained in all relevant skillsets, for financial budgets to be shared and for all interventional heart valve therapies to be done together. He adds: ‘What’s also required are regular heart team sessions and decision-making for every patient where different treatment options are available.’
Don’t miss: The heart-team based practice in 2016: space for improvement in the interaction between cardiologists and cardiac surgeons?
30 August 14:00-15:30 Sarajevo - Village 2
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About the European Society of Cardiology
The European Society of Cardiology brings together health care professionals from more than 120 countries, working to advance cardiovascular medicine and help people lead longer, healthier lives.
About ESC Congress 2016
ESC Congress is the world’s largest gathering of cardiovascular professionals contributing to global awareness of the latest clinical trials and breakthrough discoveries. ESC Congress 2016 takes place 27 to 31 August at the Fiera di Roma in Rome, Italy. The full scientific programme is here.
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