201 PCI guideline课件.ppt

* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * Every PCI program should operate a quality improvement program that routinely: a) reviews quality and outcomes of the entire program; b) reviews results of individual operators; c) includes risk adjustment; d) provides peer review of difficult or complicated cases, and; e) performs random case reviews. Every PCI program should participate in a regional or national PCI registry for the purpose of benchmarking its outcomes against current national norms. Quality and Performance I IIa IIb III I IIa IIb III It is reasonable for all physicians that perform PCI to participate in the American Board of Internal Medicine interventional cardiology board certification and maintenance of certification program. Certification and Maintenance of Certification I IIa IIb III Elective/urgent PCI should be performed by operators with acceptable annual volume (≥75 procedures) at high-volume centers (400 procedures) with onsite cardiac surgery. Elective/urgent PCI should be performed by operators and institutions whose current risk-adjusted outcomes statistics are comparable to those reported in contemporary national data registries. Operator and Institutional Competency and Volume I IIa IIb III I IIa IIb III Primary PCI for STEMI should be performed by experienced operators who perform more than 75 elective PCI procedures per year and, ideally, at least 11 PCI procedures for STEMI per year. Ideally, these procedures should be performed in institutions that perform more than 400 elective PCIs per year and more than 36 primary PCI procedures for STEMI per year. It is reasonable that operators with acceptable volume (≥75 PCI procedures per year) perform elective/urgent PCI at low-volume centers (200 to 400 PCI procedures per year) with onsite cardiac surgery. Operator and Institutional Compet