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eComment: Follow-up for femoral pseudoaneurysms

Department for Cardiovascular Surgery, University Hospital Sestre Milosrdnice, Zagreb, Croatia

Femoral pseudoaneurysms post-cardiac catheterization surgically treated: evolution and prognosis

I really appreciate the fascinating article by San Noberto Garcia and co-workers [1].

The authors stated that there is a maximum incidence of femoral pseudoaneurysms post cardiac catheterization in the summer vacation period, and that this finding urges thoughtful search of possible justifications.

When we started to investigate satisfaction between cardiovascular surgeons and co-operating cardiologists in order to define the most frequent postcatheterization complications needing surgical repair in the aim to implement a quality management system according to EN ISO 9001:2000 [2] at the University Clinic Cardiovascular Department (UCCD) in 2004 [3], 1410 follow-up consultations of postcatheterization patients took place over a one-year period. Our findings revealed that middle grade cardiologists dealt with 58% of the catheterizations while young specialists performed 33% of the catheterizations. When we analyzed the workload split (young specialist – middle grade professor), it was evident that the postcatheterization femoral pseudo-aneurysms predominantly persisted after the procedure had been performed by young specialists.

It was notable that 96% of the catheterization procedures during the summer period at UCCD were performed by young specialists without direct supervision of middle grade specialists. Moreover, in 55 patients (4%) postprocedural investigative procedures (DSA, CT or MR angiography) reported the presence of postcatheterization aneurysmal formation in the femoral region. In all 55 patients the catheterization were performed in the summer period by young specialists.

Our study has highlighted that follow-up protocols after cardiac catheterization need to introduce ‘specific staff data’ (date of birth, years of experience, etc.) of investigators who performed cardiac catheterization. Protocols, as an aid to limiting follow-up after cardiac catheterization do exist, yet implementation appears to be only partly effective. Informed education of staff and young specialists at ward level might be one way of improving these figures: staff needs to be made aware of catheterization procedure complications and given clear guidelines as to which postprocedural data might require special attention.

By implementing postprocedural follow-up protocols which include the so-called ‘specific staff data’ (referral source, workload split), the cardiovascular community could find out the reasons why the incidence of femoral postcatheterization aneurysms is highest in the summer period.

	References

Top References

 

1. San Noberto Garcia EM, Gonzalez-Fajardo JA, Gutierez V, Carrera S, Vaquero C. Femoral pseudoaneurysms post cardiac catheterization surgically treated: evolution and prognosis. Interact CardioVasc Thorac Surg 2009;8:353–358.[Abstract/Free Full Text]
2. Beholz S, Konertz W. Improvement in cost-effectiveness and customer satisfaction by a quality management system according to EN ISO 001:2000. Interact CardioVasc Thorac Surg 2005;4:569–573.[Abstract/Free Full Text]
3. Hudorovic N. Reduction in hospitalisation rates following simultaneous carotid endarterectomy and coronary artery bypass grafting; experience from a single centre. Interact CardioVasc Thorac Surg 2006;5:367–372.[Abstract/Free Full Text]

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Narcis Hudorovic Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Hudorovic, N. Search for Related Content PubMed PubMed Citation Articles by Hudorovic, N. Related Collections Related Article