When is your surgeon good enough? When do you need a "referent surgeon"?
Curr Cardiol Rep
; 11(2): 107-13, 2009 Mar.
Article
em En
| MEDLINE
| ID: mdl-19236826
ABSTRACT
Recent American College of Cardiology/American Heart Association guidelines recommend mitral valve repair in asymptomatic patients at an experienced center, assuming the likelihood for repair is > or = 90%. This has raised the question of how you define an experienced center (or surgeon). This article describes thoughts on the criteria that should make up a Center of Excellence surgical training; intraoperative echocardiography; high volume; cardiology involvement; audit of clinical outcomes and outcomes of repair; and associated surgery for atrial fibrillation and tricuspid regurgitation. High-volume programs (> or = 140 mitral valve operations per year) have the lowest mortality and highest repair rate. Although some pathologic conditions may be repaired with a high degree of certainty by experienced (nonreferent) surgeons, considerable variation still exists. Recent publications of repair rates and outcomes using minimally invasive surgery and conventional surgery highlight this variability.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Encaminhamento e Consulta
/
Procedimentos Cirúrgicos Cardiovasculares
/
Cardiologia
/
Doenças das Valvas Cardíacas
/
Valva Mitral
Tipo de estudo:
Diagnostic_studies
/
Guideline
Limite:
Humans
País/Região como assunto:
America do norte
Idioma:
En
Ano de publicação:
2009
Tipo de documento:
Article