Wadia Subeer K, Accavitti Michael J, Morgan Gareth J, Kenny Damien, Hijazi Ziyad M, Jones Thomas K, Cabalka Allison K, McElhinney Doff B, Kavinsky Clifford J
Department of Internal Medicine, Ronald Reagan UCLA Medical Center, Los Angeles, California.
Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois.
Catheter Cardiovasc Interv. 2017 Sep 1;90(3):418-424. doi: 10.1002/ccd.27151. Epub 2017 Jun 1.
Interventional catheterization is central to the care of Adults with Congenital Heart Disease (ACHD). Current standards for care provision and training in ACHD intervention are lacking. We sought to examine trends in current practice and training among interventionalists.
We analyzed the results of two separate international surveys in June 2016. One was sent to all active members from the Society of Cardiovascular Angiography and Interventions (SCAI) who self-identified Structural Heart Disease or Congenital Heart Disease as a practice area. The second survey was conducted through the Pediatric Interventional Early Career Society (PICES) aimed at pediatric and adult congenital interventionalists in their first seven years after training. The total survey sample sizes were 1,535 and 112, respectively.
Response rates for the SCAI and PICES surveys were 15% (237/1,535) and 75% (84/112), respectively. Most respondents (74%) worked at institutions with pediatric and adult facilities in proximity (major medical centers). While 75% of SCAI respondents believed complex transcatheter procedures should be performed by ACHD-trained interventionalists or multidisciplinary teams, only 32% reported such care is being provided at the present time. Most pediatric and adult cardiologists surveyed (73%) do not believe current interventional fellowships provide adequate training for proficiency in ACHD interventions.
ACHD management remains underdeveloped in relative terms, particularly in the United States. Significant gaps in interventional standards of practice and future training needs were recognized by this study. Our survey should serve as an impetus to establish training guidelines for physicians who seek to perform ACHD interventions.
介入导管插入术是成人先天性心脏病（ACHD）治疗的核心。目前缺乏ACHD干预的护理提供和培训的现行标准。我们试图研究介入专家当前的实践和培训趋势。
我们分析了2016年6月两项独立国际调查的结果。一项调查发送给心血管造影和介入学会（SCAI）所有自认为将结构性心脏病或先天性心脏病作为实践领域的活跃成员。第二项调查通过儿科介入早期职业协会（PICES）针对培训后最初七年的儿科和成人先天性介入专家进行。调查样本总量分别为1535人和112人。
SCAI和PICES调查的回复率分别为15%（237/1535）和75%（84/112）。大多数受访者（74%）在附近有儿科和成人设施的机构工作（大型医疗中心）。虽然75%的SCAI受访者认为复杂的经导管手术应由接受过ACHD培训的介入专家或多学科团队进行，但目前只有32%的人报告提供了此类护理。大多数接受调查的儿科和成人心脏病专家（73%）认为目前的介入进修培训不足以使学员熟练掌握ACHD干预。
相对而言，ACHD管理仍不发达，尤其是在美国。本研究认识到介入实践标准和未来培训需求存在重大差距。我们的调查应促使为寻求进行ACHD干预的医生制定培训指南。
