#JustReleased ACC/AHA 2019 Appropriate Use Criteria for Mult
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Published recently in the Journal of the American College of Cardiology is the second of 2 companion appropriate use criteria (AUC) documents developed by the American College of Cardiology, American Association for Thoracic Surgery, American Heart Association, American Society of Echocardiography, American Society of Nuclear Cardiology, Heart Rhythm Society, Society for Cardiovascular Angiography and Interventions, Society of Cardiovascular Computed Tomography, Society for Cardiovascular Magnetic Resonance, and Society of Thoracic Surgeons.

The first document addressed the evaluation and use of multimodality imaging in the diagnosis and management of valvular heart disease, whereas this document addresses this topic with regard to structural (nonvalvular) heart disease.
“The goal of the companion AUC documents is to provide a comprehensive resource for multimodality imaging in the context of structural and valvular heart disease, encompassing multiple imaging modalities”, the authors write in the guidance document.

The following are key points to remember from the multisociety document:-
1. Transthoracic echocardiography (TTE) is considered “appropriate” for the initial cardiac evaluation of a known systemic, congenital, or acquired disease that could be associated with structural heart disease.

2. TTE, cardiac magnetic resonance imaging (MRI), or radionuclide ventriculography is considered appropriate evaluation after appropriate time interval following revascularization and/or optimal medical therapy to determine candidacy for implantable cardioverter-defibrillator/cardiac resynchronization therapy and/or to determine optimal choice of device.

3. TTE, transesophageal echocardiography (TEE), cardiac MRI, or cardiac computed tomography (CT) is considered “appropriate” for initial evaluation of cardiac mass, suspected tumor or thrombus, or potential cardiac source of emboli.

4. TEE, cardiac MRI, or cardiac CT is considered “appropriate” for comprehensive further evaluation of dilated aortic sinuses or ascending aorta identified by TTE.

5. TEE or intracardiac echocardiography (ICE) and fluoroscopy are considered “appropriate” for intraprocedural guidance for closure of patent foramen ovale or atrial septal defect.

6. TEE and fluoroscopy are considered “appropriate” for intraprocedural guidance for left atrial appendage occlusion. ICE “may be appropriate” in this situation.

7. The writing committee states that the modalities are not to be considered in a rank order and may be used relative to individual patient circumstances and the balance of risk versus benefit.

Read in detail here: http://www.onlinejacc.org/content/early/2019/01/02/j.jacc.2018.10.038
Dr. S●●●r A●●●d
Dr. S●●●r A●●●d Internal Medicine
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Mar 8, 2019Like