(Interventional Cardiology)

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Lester Robbins
5 years ago
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1 ! " # $ % '() *+,!&! & (Interventional Cardiology) /./ ( " # 12/

2 #71 8 ' 9! " # '() *+,!&! & (Interventional Cardiology)

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5 m m'( d% `)Z )#" N( n - #;' M I)M 0'; : ;(m'! "] )#" 0AH > 0AA A98] B $I.9 #F ] B I% V plim UA 0AH _ F -S/ ( Non Invasive) ;(' Z ( Invasive) d% /( Z ;(' 0AH 6# 9; F $V# q `)M /( $; e 0#7 7 D! Q/ $/ 0V _ 9 #8? B (Percutaneous) V1 1 V K DmW4 _mi)m 0mAm+ _m1 V Km _m Km -mf mm I)M U#7 0A9;7M ;A m m rm> mf4 sm m4 B t8 F #8 * Z $ _m )#" 0AH + B #7 ( *) _ F $7 R K `)M 0 )> DM Km `)M u!"# *FRB A F U 7 S!#> 0A>F -mm D' S> HL $7 R K `)M 0 )> DM q UA > $S 0. ; `7 :IM Km `m)m 0 m)> DmM m) ;* tmq F4 DQ K8 (.mf m Hm4 m A H4 R 0 I ; D! $7 R N%m 0mAm 4 _!!" 1 / N 98] B 9 ' 0m# ; _ m m m 0. A> ; $7 R K `)M 0 )> DM /. 0A=] #> Q/ # D7)( 0R R w 0# ; u"] vi# D t!!" ) ;* 0 0# ; $7 R K `)M 0 )> DM. ; ;F D'] B _ # ;. 9 M 0 : Interventional Cardiology : #mf `m] :m m!k!" m) ;* s $7 R K `)M 0 )> DM DL>m m 4 m#>4?m m mf K `)M 0';!!" K8!!" m m)> m.; 9 :8.7 R K `)M /j( Z! "] ;('. F A> e ; D! 0

6 :! "#. A> 18 F4 $% : $ % &&'(!!" ] 0 K `)M 0'; u!"#!!" K8 ] 0 K `)M 0'; u!" K8 : )* +,' : 9k Q _ 1958 $ Mason & Sones M4 t 8 W4 e ;Q J _ u"] 4! F 9 F 8! 1 0# 0 H $# 8 x4 _98 K `(/ t8 ' *: _ K 0;! "] 0A98] B 0 F Charles & Dotter _ 1964 $. /( 0AH 6# I% -F F F Q s 0 # I F (#! "] 8 x4 e ;Q 0 F = ( -M?A > (?R8 c ) seldinger H. 0 = B P1 1 V WF #LBx4 Judkins Dotter F q. yz 0 ;(' DM - '7 $;8 F 0 -M/ v( e A97l: t DQ 0*# _ 8 x4.98 M ( `)M /( ; > ( Left >F 0 #LBx4 : 1977 $ Andreas Gruentzig UA $ 23 e : 38 ; s LAD ( anterior descending F #> A _ A: _ C - F #> q. Q.F -S/ H '( -M 98] B 1987 $ Z 0A9# `)M 0 )> DM?.?A 0A= 0A9#? B `)M 0 0'; _ I)M 0+ 0'; +;A A = $7 R K.F 98] B $/ F #] UA 1 V K DW4 0'; : 9k Q R $7 R K `)M 0 )> DM 0AD' '( 0A98] B D e) =] #7 ;> e #; `)M?".9 ; F '( -M V

7 0 # 9 em F W?" : 1370 $ ' *FRB -M p#i7 _A#'F ' = R hb 4 ; ;A 9V # H4 `)M 0Au!" K8!!"# '(. M ( W ] {> -> 0A= *;A 0'# :8?R8 $/ 0A] #Fw 0AA % M : % -. -I)M 0'; M -I)M 0'; y n ) 17 _ 2001 $.9 #F 0 =;] F? B.9 $/ 0A] 4 %80 9 #8 K6 '( _ 8%.F ) 26 ~: '( M -I)M n R * 2020 $ $/ M -I)M 0'; y #8 9 0': #8 R ARA ti (; #89 $ : DALYS*) : ) 145 0V 9?R8 v;.#8 K6 $/ 0A] 4 %86 F '; 1 A] `)Z F '; F _ n / 3 $/ 0A].9 '7 n e $ 9) ; #8 9 $ 9) 0RY #* Ä/ _I)M #* ] f 4 A % ] $7 9 ;( S?R8 = 0.F 9) ]# HR J.F ] M -I)M 0';. v F 1> %56/9 _ %47/4 ) %52/29 _ : >B 8 S _ 1386 $ ] # AH ; ( 0A 0 _ 9 0Q _ w: _ F ( 9: DQ _ #7A ;('U 0AH `:% #] e U = '. 9 ;? B? A F 1 H#7 4 ) 0 R 08 U) _ '; L# R?R8 D * Å I' -! "] 0'F 9 #F 0 =;] 0'#8] B $; 7 (... 0w 9# #LBx4 :) ;(' #; 0'F #8 R x ] )#" Ç.9 #F R F /( -! "] D* q R ] w:.9?r8 0; ` u "] * #8 H#7 '# * Disability Adjusted Life Years. AHL * 0 9'( _ 9 0Q.A?A ; J# 0#7 D _ ;('U DM *

8 :! " % /&'( 0 1 _] ( É =] 10 _ s É =] 9 ) =] 19 _ ( 1389 ) Q/ $/ 6 10 _ s É =] A 0. F 9 K `)M u!"k8 u!"# R 0 _ U Interventionist 6 5 _ É 0A=] 0! R K8 0A# S!> R 0 +. A> F4 R?FB 0. A> _ U _ U 6 2 # A 0 _ M 0A# S!> #: pi (!!"#. F / 0 - _ F {> 9> S 4 $ 10 % U Ñ8 0.F ;" / 4 $ 10 0 Philosophy (Beliefs & values) : : (4 4 ) 2 ;#( I% _ x _ h( A : F 0AH 0V9L 9 6 ]"I' 9L 9: ) 0A9: 9 _ ti _ ]M ;A 6 9> W `Aw 08/ KL> 9 Mission : : (07) 06 9!!" ) ;* N1 '# ; _ 4 0A 9 _ 9: u "] > : Ö A#>4 _ >!!" C e L #> ( #' _ K `)M 0A0; ( Interventional ) 0)> 0A. A M ( /4 Vision : : ( 9:;) 8 0 mm! " ] Dm> _ mf4 0mAm _ m4 $m 10 m. A> 1 0A] _ U) : '( 0A#

9 Expected outcomes : : (<! = : F M M 08/ y ÇI A 8 _ =!!"# DS! "] * #' Ö"# 0. F #F - 9L U `:M t)7 ti ; #IM _! "] _0 =] B 0AH.A e 8 D'. * > _ ; 0 R 0AB 9C6/ 0AH - 0*;A >!!" _] X1 A=] ]AxB e@.f #F.F #F %!!" 01 / )#" 0A H4 e. $7 R K `)M 0 )> DM 98] B $/ 0AH A08.; 0 = B '4 q# F F4 ;#7 1.]" Å ( 9L 9 Q _)#" 0A*A 0 * '] B Roles : _0 =] B _0] _#IM : * (<! =?4=! "] 0A? =#>4?. 6 ( # ]AxB _F4

10 Tasks : : (<! =?1 A : #IM! "]? (: :am7 9Lm U m 0mÜ _ ; A;A _; 08/ ÇI 0M 9L e@ ti q# 9Iy ;!!" $/ PF #8 m m! "] 0mA97 e * )B D]4 1 9> {!!" 0A] 9> -*] e=a u "] 0)> DM 9'( ; X VS Ö"# I# AF #I W m! "] 0A-B 9 I em DmQ m W m; 0 H * ` Ö"# ;('U ;(' B A B e -IM _ 1 t)7 / 0A B e ; * DL> e 0 ` ) Ö"# B e / _ -IM ; 9IM 0; Ñ e=a u "] ; 0 = B ti *FRB c ]"I DM R : 0]? (Ö ) m= 0'm 9Lm e@ *;A _A;A _;!!" ] W (... M *FRB _*FRB e@ +;A : 0 =] B? ({ 9L e@ ti!!" 1 / 9L 0A0w=# 0*;A 9> DS DS 0=:Z =] B 0A 9] 0*;A ( > _ ; 0 =] B D L> e ( Protective ) #C6/ 0AH 0 * % #; 96 $# / 0*;A : F4? ( H4 er: 9L U 0Ü _A;A _; ti DQ H4 ( A=] 4 98] B 0 )( 0; y 0 =] B ; ;A

11 0; 0 = B ] : 0 =] B ; =#7 A;A ;A DS ti!!" e H4 0A 9] ( Life Long Learning ) ;:e 0 ti!!" 1 /! "] 0A-*B 9] : ]AxB? (ma m ' _d V HR ' _ / A - )V R _ V 0AP% '] B q# ] ;) :!!" 1 / ti 0] 0] 0A?AxB 0*;A : #? ( ti!!" 1 / 9L U 9 DS!!" 1 / ti 0A/ R 9

12 : >( 4?8 Expected Competencies & Procedural Skills : (General Competencies) : : 8?4?8 :6 : DL% 9Iy 04 (communication) ÇI 0M!!" $/ PF w> ;!!" * )B D]4 1 9> *FRB c DL% 9Iy _B - *] : ; 0 0 U ;! u "] _ : $.# 0A97 m H 97 q# m ECG 76 * )B D]4 76 `)M 0A8 v 76 m f# #:A m 0#7A *FRB m MI)M m > 0A97 76 m Fe 0A8 x4 q# m / K / sl:; A m sl: * )B : 0A#8 ez (clinical judgement) : DÜM {## ; 0 e. 0A] 9> 0; u "] ; )a7 -/ 9'( : 0 U ;! : (Patient Management) ; (Patient care) ; 9IM (order "7 #F) 1 R ; 0 4 0( -! "] * #' Ö"# V6S { ; * DL> e 0 ` ) Ö"#... Ñ 0 ` H Ö"# ]"I DM e *FRB ] 9> ; v( e. 0A=A;A ; H4 ; 0 = B : = 0A0;?AxB 9L U 0IA 9!!" 0A] W (Advocacy) ; 9;/ * #*: N ;) DL% 0#7( - : F F4 K8 0A0; ) >!!" _ # : w. 9 #8 M p _ K8 9 ;A

13 : ( -& ': BD) : C D8 -M/ 0 -#7 e (Procedure) B post bypass ; hl ; _ 1>B ; 8 x4 1 V K 8 x4 (1) (PCI) K #LBx4 *("#) $# + #LB:: *("#) ;:B + #LB:: *("#) #LBx4 *("#) R 1 V K #LBx4 *("#) `)M 0 0'; 0)> 0A mb e e *: _ I H4 # ( B e * 0R 0mA mw er)#m7 _ Km8 0A mb e *: _ A" )!V#: á8 N R. F % F4 R W ( Advance short courses ) #8] B Intervention ( PCI ) -Percutaneus Coronary #LBx4-9# 0w ( - #*I - ( Chronic Total Occlusion ) R Bifurcation PCI - (1). F S PCI H4 % R e ( IVUS ) M -> 8 #: - Rotational Atherectomy - Fractional Flow Reserve ( FFR ) - 0A `# _ PCI K8 0AD' j-#7 e -IM _ # : U' jw e s; A] k #7 _ F4?" _ F4. g D'

14 : (FJ84) -< G H$ % I 4 4(F : Fg;A 0A _ $]# 0l: _ $]# 0l: _ K `)M 0 )> DM `)M /( _ K /( : F!?4K4 (0@ ) V ] _ (); ) V # -*] -/ #I 08/ C #I #; H4 Teaching & Learning Methods : : (? L 4?4)! 4 `: 9 ); H4 `: - * F4 F4 6# 8 x4 76 H4 A=VIS HR 0AH 6# _?" : H4 ]"-> 0Ah6 hl #*: = H4 Ü/ ( Didactic methods ) F4 0AJL 0AH #: 6# H4 F4 ba `7/ F4 0AH 8

15 D () 18 DM -0#V ="B 9] B -IM ; 9R di% #> 0A] ; 0 = B 0R m B ; 9R : F! I (< / _?" H4 S 0A?" 0#7 = $% $% $% 2 â/ J %! "] 0A B e di% F4 R ]AxB 0AP% 0*;A àb 0A0 U ;! m % hl ; 9R #> 0A] `: 9 D V / hl?" "#?" : BM N ( tf d1 Ö K8 C e F4 0R *. F #F F4 0A?" D* ( DS _!!" 1 / # 9 R _ F S *. ; em Skill-Lab 0 r!> D 9 # ti?" s 97I *?" h W 98 /LS _ AH4 R {> -> â/. F #Fw ( 08 0AD' Ö"# # t 8j PL!i R AB 9C6/ w 0 _?" 0R # *.F

16 : 6 &&' O8 9 P % Knowledge Foundation (Anatomy for Interventional Cardiology) (Coronary Circulation, Renal, ) (Valvular, Arterial, Ventricular) Equipment : Construction and Performance (PCI Equipment, Stents, Adjunctive Devices, ) Principles and Catheter Laboratory Equipment Pharmacology (Antithrombins, Antiplatelets, Thrombolytics, Radiographic Contrast Media, ) Procedures Diagnostic Procedures Coronary Balloon Angioplasty Coronary Stenting Distal Embolic Protection Complex Lesion Intervention Valvuloplasty (MV, PV, ) Device Closure Peripheral Arteries Procedures Complications and Management Medical Management of Risk Factors Preclinical and Clinical Trials Reimbursement Principles of Innovation Dose monitoring radiator protection

17 : ;= (Professionalism) FC *E D; FC *E ' R-I #F =#>4? # ;= J # C -GH.A X ( > N8 ; N8 (1. 9 9: )#" ; '( (2.F #F ( 4 ;#( _;7( e; ; > (3.; bs 8 9M ; 9IM -/ ; (4.F #F ( ; e.4 A #> (5. v8 4 9 )#" tf ; K/ ] (6 H L( =7 M N # C -K.F #F 8 ' > WC e 9I7 (1.A àb ; D. (2.A M A;A 0 #> F #I ; 9 Q Ç DL% (3.F #F - 9L U 0Ü ; R AB *;A 0'#:> (4.; 9 :a7 J7/ ; $# 9IM -/ ; (5. = ( ;! "] A e _I/! 0 (6 9 6 I' R 0; $# _ 0L# _Ñ _0; ] 0 =] B 1 (7.A H4 ; ` % ;= F # C -O.F =# (1.F *# (2.F (3. ; 9 ; S!> U/ (4 P/ 8;C # C -.w= e#/ ; D e _ Ö4 _ (1. e#/ 0 D!"] e _ 7 s ; (2.; 9 ` U@ #Fw e#/ ; 9M (3.w= e#/ U *;A_; A;A (4.F 0 8/ af d1 '4 0AC 9 Q (5!Q H@ # C -#.F wb # (1.A" s; ] e. _ #>F > ;) 0A 9V (2.AÅ > 0';?_;#7 % (3.A e J# ;) 0A# D* d1 `! "] DM ( HR *FRB B - ;* 0A# (5

18 ? $ V FC *E 7/F UER "+??- II: > # s; F4 0A t V 0 8/ KL> U *V 0# _ # :; HL DM 9'( :,=7 / F $/ 0 S?F T"0 F4 0A t V S!>!"F e 0 ` tf #> UA8 Z D e=a B B ( #) sfrb *FRB D ) ev ;A ; h;a #B s Ü/ ; ;A ; M UA U#7 UA8 #_ A;A_ ; =A8 0A `# ; a;1_ ` t V Q# 0? ; -V #> 8 : /B?7/F UER T"0?" 0( 0A ( 0A48 PLS 9'( #; ( 0*;A ] U ; 0% ; u > DR ' 0#7 _ HwB 0A. % 4 A #; ( U* 0 W ; 0â/ 8 D> 0 W - '7 9'( #; W( 0A8 ( #; /LS D'] B :,=7 B S?F T"0 F4 0A t V R 4 e#/ ; ;S ( 9] F4 0A t V V ' A bw/ 9'( HL 0 #F ]" y ` 0A 0*;A ; 0A 9] A = 8 B $ # _ ` *); NM d] F4 :a7 A=: 8 9] Role modeling 9 $8 9] 08 D%I 9 9'( HL (Priming) 8 F4 0A -;:# 0 W 0*;A 9] 9L U 0Ü ]_# ;#( 0_ 0 K/ 9 : V " 2? W/ _ `Aw _ xa ) ;#( _ ;7( U ; *FRB 0 _ 0 K/ 9;/ tf e; _ (;#( 0!#M I% h( _ 0 K/ 9 9'( ; ;% ;# `)(

19 Z 0;A _ F> _ L? B ; ` ;#( ÇI tf ; ; D. )S/ ="B = 8 B $ # ; D. ` ="B 0 V H4 4 B $ # 8 +;A _; $a7 sfrb > 8 ; D!"] e #B tf UA8 s; ; A8 DL; e;v# _ Ö> _ wz D?B A 4 0.; 08 9F' ( 0 F4 0A ; 0wZ ; ( tf 0 F4 0A 4 8 $; 0 ; 0A ( 4 S!>! "] DM 0 )(Patient Safety) ; ; ( _?" `Aw 4 A _ Q# ; )? ; 0 4 tf UA8 s;. d)1 9/# $/ ; 0_ x. tf ) ; 9!"F e#/ *FRB D e=a ; `?FB ; > A;A ( e#/ ; 0 ;?FB v 0!#M 9 Q ( DR '?4 _ A R 0Q Z 9; M D]4 9> Ö#( ; 0 ; DL '7 #8 ` 6# ; -/ -M DL*] N8 _ 0 PLS 0i N( A/ ÇI! "] 0A B ) D e 0 ; 9Q `)( ( w> A 0 U ;! ; 04 $L# 9 ; () S!> -W7 0]8 0> 0#7 I D A "] -W7 0 ; e. DL% 0 W Z : 0 STEEP 9_ v; ; (safe) ; D> 0 W - ; (Timely) NM 9> 0 W - ; (Expertise) 8 0 U) 9> 0 W - ; (Efficient) PLS 8S yz 9> 0 W - tf 0 ) (Patient Centered) ; 9V - : *E $2 = JEX, Y 01 = 8 B $ # 0 8/ y ` ÇI H4 ] B $ # 0 8/ KL> -W7 H4 9]?" ML> D Dress Code D _ ; M/ ] vl% H4 = 8 B $ #

20 DFR ); 0@ F4 0A 48 A 9 :8 ) ML> D* ;#7 F -; 0A K A = _ A h6 _ A _ A=VIS = 8 # _# Ü/ =#6A D7)(?" 0( 0A48 ML> *FRB 0A1> DM Å ) F4 8*F äv tf UA8 = 8 # _# Ü/ =#6A D7)( 4? B( Malpractices ) ; H4 0A _ )#" 0A 8 9] :!"B &E /= P/ )F. / '= ;= ";( B,!B U _ {7 R 4 e#/ > F D8 7( R 4 e#/ > F D8 > 0;A? 0/ ; I ã6/ A e I% *); _ ; 0Ü ã6/ 0'= A ( 08 : 61 _ ( K/ e#/ 9 0 9M D8 Ö#( ; s; L% 0A 9M 9 ;A > 0Ü ã6/ 0 ; hf #8 s ) B 0A 9> 1 R! "] DM A R _ : 0A 0 U ;! 0 ) Clinical Governance 9 : )F ";( D 9/ = F4 0 0A A=VIS DFR ) F4 0A ) Ü/ 6) 0 = B _ 9 :a7 0w d% 8 Ü/ D@ ( Z IF 0A s _ A hl A = ] _ A s ] Ü/ = 8 > ;#( 0wB 9 :a7 hl ; : NM Ü/ U@ _?FB V _ ;#( %I *); 8 > ; *); ( =: = 8 > W _ Dress Code D 9 d% ( ÇIÜ > _ ;!!" D $/ PF w> 8 >!!" *); ( : DÜM {## _ * ) B : 0 A #8 ez 76 _ D]4 1 9> % _ DM e Ö"# _ 1 R _ : 0A0 U ;! _ 0; u "] _ 0A R8 e 6# _ ]AxB DM _ ; v( _ *FRB 0A ] 9> U #7 D@ `)( c n.;#7 - ;* 9 ;A d% ( ; 0 = B!!" ( Malpractices) *FRB 0A1> A *); Å 8 #.?AxB KL> # ; 0A -;:# J A B ]AxB KL> 9. t)7 4 # A H e ; {> D V e Ö#( 9:' 4 Q/ $/ 0% _ *FRB 0 A B - ;* V 9 ;A. F 6# -M

21 :; $2 FC *E R; - III ;(' em #; ` #' Ö"# 0A ' 4? B _ :;#/ Ñ D1> _ U ;! ); d M _ - vl% A;A _ er: DS ; ( Alternative ) R=( )S 0'] B A B e 04 _ $# / _ `: 9 x _ ; S!> U/ ã6/ *FRB DR ' v 0 0A9F DY )I ÇF M HwB Ö#(

22 References : : 0 * -D %! )! 2( I Q Interventional Cardiology Spencer King III Topol Interventional Cardiology : - : - 1- Journal of American College of Cardiology (JACC) Interventions 2- Circulation, Cardiovascular Interventions 3- Eurointervention 4- Catheterization & Cardiovascular Intervention 5- Journal of Interventional Cardiology 6- Journal of Invasive Cardiology : X Q F A> V#; 9a A t _( 0A W4 J _0] 0'4 N (1.F ]# É F)8. 0( 0 9 ;A N.9 J# F å "7 _`# (2 $% 9 _DL (3

23 Student Assessment : : ( : (Assessment Methods) H - mm DOPS m mi# m A6mF : 0mAH _ m #m m 0m _ 0 0mAm qm# : -mf :8 DB 0 ) 0A. F 6# Dw Ad] _ D. _ ); m ;) 0A9 :8 HR _ cn. : (Periods of Assessment) D8 -Ö A H4 R )> di% : ( A RF.F (. e. 9 mf 4 % 0A W4 # M C PF : I ; ç 4 0 {> 6# e e -!V D % 9M e; 9 :8-1.% =].F4 b% :V C e -2 DL * å 0 : s HwB ]AxB P% s -M/ e -3. F I# ; 0 = B 0x# 0( 9] = ; 9R -4?" di% AÖL$l Ah6 D7)( W -5.?" di% `: 9?" :V C e -6!!"!!" ) ;* B 0A # H4 9] -7.?" B e -IM ; 9R I' Q ; x _ ; 0 = B -9 di% 7l ; $*4 s ] D :V C e -10.?"

24 : (K -=L -)?*? 8 0S 4 -D1 Interventional I# c _;) D A 6 3 _ ;) D A é A _$/ A. F. ] 4 6 s -M/ 9 Cardiology.F ;) D A 0Ü #] H4 $/ # I 1F :?*? II H4 0A 7 * #B : &&'?4=' 4G #7 _ ç K `)M!!" H4 0 0AÜ8 ) : F J# % =] `)M )>?" - 0#7A *FRB?" `)M 0 04?" - 8 /!!" = - 0l:?" )>?" - K `)M /(?" F'?" : " U?4?8 -D1 T 400 0; ( #LBx4 ) K 0; :! "1 ( 0? 0' 0 # A 0 9" 8 m?" 0 9" 25 -M/

25 : &&' B+ BV )$ (=# -M/) 8 x4 =# Transe Eusophageal Ecocardiography (TEE) 8 =# Intravaculare ultrasound * IVUS =# É;B : =# Fractional Flour Reserve * FFR =# Å / #8] B DR ' * Rotablator Activated Clothing Time ACT =# * Aggregometer. 97 R: : _ 9 ` AH4?" DR ' (* : (4?* $ I 4:?4 : 9 0 A=] R. F #F K `)M!!" N1 # H4 s -M/ (1 9F!k!" N1 0 # 0( 1M k 9>?" (2. F. F { 0A-M/ 0 (3

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SPAREPARTSCATALOG: CONNECTORS SPARE CONNECTORS KTM ART.-NR.: 3CM EN

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