New Advanced Training Statement on Interventional Cardiology: Key Points

Bass TA, Abbott JD, Mahmud E, et al.
2023 ACC/AHA/SCAI Advanced Training Statement on Interventional Cardiology (Coronary, Peripheral Vascular, and Structural Heart Interventions): A Report of the ACC Competency Management Committee. J Am Coll Cardiol 2023;Feb 16:[Epub ahead of print].

The following are key points to remember from a new Advanced Training Statement on Interventional Cardiology (coronary, peripheral vascular, and structural heart interventions):

  1. This American College of Cardiology/American Heart Association/Society for Cardiovascular Angiography and Interventions (ACC/AHA/SCAI) Advanced Training Statement addresses the core competencies required of interventional cardiologists, including competencies related to coronary, peripheral vascular, and structural heart interventions and provides examples of appropriate measures for assessing competence in the context of training.
  2. The 2020 Accreditation Council for Graduate Medical Education (ACGME) Program Requirements for Graduate Medical Education in interventional cardiology require a single designated program director and ≥1 additional clinical faculty member or a ratio of 1.5 core faculty to fellows for fellows with >2 fellows. For peripheral vascular or structural heart disease intervention training, dedicated faculty with expertise in peripheral vascular intervention (interventional cardiologist, vascular medicine, interventional radiology, or vascular surgery) and structural heart interventions, respectively should be adjunct program directors.
  3. Training components should include a defined didactic program; clinical experience; hands-on procedural experience; ability to diagnose and manage common clinical conditions, emergencies, and complications; and development of a strong foundation of scholarly activity specific to the area of training (coronary, peripheral vascular, or structural heart interventions).
  4. Curriculum milestones for Level III training in interventional cardiology (coronary, peripheral vascular, and structural heart interventions) include well defined goals in six domains: medical knowledge, patient care and procedural skills, systems-based practice, practice-based learning and improvement, professionalism, and interpersonal and communication skills.
  5. One year of additional fellowship training in interventional cardiology after 3 years of general cardiology fellowship is required to be eligible for Level III training. In addition to competencies outlined for Level III training, volume requirement of a minimum of 250 interventional procedures (200 percutaneous coronary intervention and 50 additional coronary, peripheral, vascular, or structural heart procedures) and ≥25 coronary physiology and ≥25 intracoronary imaging procedures are required.
  6. Additional training in peripheral vascular interventions requires 100 diagnostic and 50 peripheral arterial interventions (half as primary operator), 25 carotid interventions (13 as primary operator), 20 endovascular aortic aneurysm repairs, and 20 peripheral venous interventions.
  7. Additional training in structural heart interventions include a minimum of 50 transcatheter aortic valve interventions (25 as primary operator), 50 lifetime transcatheter structural heart procedures (minimum of 20 transseptal procedures, 20 transcatheter mitral valve edge-to-edge repairs, 15 atrial septal defect closures, 12 patent foramen ovale closures, 10 left atrial appendage closures, and 5 mitral balloon valvuloplasties.
  8. In addition to clinical competency, interventional cardiology trainees are expected to function effectively as leaders in allied efforts to ensure high-quality care and promote individual and population health.
  9. Trainees must be evaluated regularly with respect to clinical judgment, case management, and procedural skills, including the integration of clinical findings and the results of noninvasive testing and invasive coronary or peripheral angiography to make an accurate diagnosis and formulate a comprehensive management plan.
  10. An important component of the certification process requires the interventional cardiology program director to certify trainee competency in procedural skills as a prerequisite for sitting for the board certification exam.

Clinical Topics: Cardiac Surgery, Congenital Heart Disease and Pediatric Cardiology, Invasive Cardiovascular Angiography and Intervention, Noninvasive Imaging, Valvular Heart Disease, Atherosclerotic Disease (CAD/PAD), Aortic Surgery, Cardiac Surgery and CHD and Pediatrics, Cardiac Surgery and VHD, Congenital Heart Disease, CHD and Pediatrics and Imaging, CHD and Pediatrics and Interventions, CHD and Pediatrics and Quality Improvement, Interventions and Imaging, Interventions and Structural Heart Disease, Interventions and Vascular Medicine, Angiography, Nuclear Imaging

Keywords: Accreditation, Aneurysm, Angiography, Atrial Appendage, Balloon Valvuloplasty, Cardiac Surgical Procedures, Cardiology Interventions, Certification, Clinical Competence, Competency-Based Education, Coronary Disease, Curriculum, Diagnostic Imaging, Education, Medical, Endovascular Procedures, Faculty, Fellowships and Scholarships, Fellows in Training, Foramen Ovale, Patent, Heart Atria, Heart Valve Diseases, Myocardium, Patient Care, Percutaneous Coronary Intervention, Peripheral Vascular Diseases, Professionalism, Radiology, Interventional, Transcatheter Aortic Valve Replacement, Vascular Diseases

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