Recommendations on adult congenital cardiac interventional training

The Society for Cardiovascular Angiography and Interventions (SCAI) has released a position statement on adult congenital cardiac interventional training, competencies and organizational recommendations. The paper was published online in SCAI's official journal Catheterization and Cardiovascular Interventions and addresses the rapidly growing field of catheter-based interventions in adults with congenital heart disease.

Congenital heart disease (CHD) is the most common congenital abnormality and occurs in ~0.8% of all live births. The number of adults with CHD (ACHD) in the United States now exceeds the number of pediatric patients.

The statement, also endorsed by the Adult Congenital Heart Association, focuses on three major areas: eligibility for training, training environment and duration of training, and procedural volume. Key recommendations include identification of four main training backgrounds for candidates and individual determination of training period(s). The writing group specifies that during an ACHD interventional training curriculum, trainees should participate as primary operator or first assistant in at least 150 ACHD catheterization cases (100 should be interventional procedures).

"The writing group included representatives from the areas of adult congenital cardiology, pediatric interventional cardiology, and structural interventional cardiology," said Jamil Aboulhosn, MD, FSCAI, chair of the writing group and director, Ahmanson/UCLA Adult Congenital Heart Disease Center. "The recommendations made have wide applicability to trainees and established interventionalists from a variety of clinical and training backgrounds. In addition, the statement affirms the importance of institutional and team staffing, procedures and processes to ensure delivery of high quality invasive cardiac care," he continued.

The document suggests that training of future specialists for this specific population be delivered by multi-disciplinary teams that combine adult and pediatric expertise in a collaborative approach. In conclusion, members of the writing group recommend multi-society collaboration to help establish and maintain competency standards for physicians.