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J Thorac Cardiovasc Surg 2006;131:530-532
© 2006 The American Association for Thoracic Surgery

STS/AATS Position Statement

Guidelines for Credentialing of Practitioners to Perform Endovascular Stent-Grafting of the Thoracic Aorta

Nicholas T. Kouchoukos, MD, (Chair), Joseph E. Bavaria, MD, Joseph S. Coselli, MD, Ralph De La Torre, MD, John S. Ikonomidis, MD, Riyad C. Karmy-Jones, MD, Robert Scott Mitchell, MD, Richard J. Shemin, MD, David Spielvogel, MD, Lars G. Svensson, MD, Grayson H. Wheatley, MD

Task Force on Endovascular Surgery, Workforce on Adult Cardiac Surgery, Council on Education and Member Services, The Society of Thoracic Surgeons, Chicago, Illinois

The first 20% of the full text of this article appears below.


   Background
 
Recent innovations in endovascular grafting technology have made the endovascular treatment of thoracic aortic aneurysm, dissection, and other thoracic aortic diseases a viable alternative to open surgical repair. Like many new surgical procedures, thoracic endovascular stent-grafting presents challenges to physicians who care for patients with thoracic aortic disease. When new surgical procedures are introduced, the pressure for rapid adoption can lead to deviations from the fundamental principles of physician education and training and from the established indications for operative intervention. These deviations may compromise the quality and safety of patient care.

As with any surgical procedure, appropriate management of the specific underlying disease process involves several distinct but interrelated components. First and foremost, the involved physicians must possess a broad understanding of the disease entity. Second, they must possess knowledge of, and expertise in, all of the available therapeutic options, including, but not limited to, the new technique that is being applied. They must be able to care for the treated patients in the post-procedural period and to deal with the potential complications of a specific therapy. Third, they must receive technique-specific training. To enable physicians to meet these basic requirements for thoracic endovascular grafting procedures and to become credentialed to perform them, specific criteria for all three of these categories must be established.


   Disease Process
 
Knowledge Base Recommendations
In many patients, thoracic aneurysms, atherosclerotic disease, and aortic dissections involving the descending thoracic aorta coexist with other morbid conditions. This complexity is further heightened when the aortic disease involves the adjacent ascending aorta, aortic . . . [Full Text of this Article]




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