Dariusz Dudek (Krakow - PL) 13th Experts "Live" CTO Workshop 17th–18th September 2021 - Florence, Italy

1. Dariusz Dudek
Institute of Cardiology, Jagiellonian University, Poland
Maria Cecilia Hospital, Cotignola, Ravenna, Italy
President , EAPCI, European Society of Cardiology
EAPCI – key messages & CTO training

2. Unifying knowledge, expertise
and understanding of CVD
Stronger Together
The full spectrum of cardiology

3. EAPCI activities
EAPCI Mission:
To reduce the burden of cardiovascular disease
through percutaneous cardiovascular
interventions.
EAPCI Vision:
• Identify and break down barriers to improve
access to all percutaneous cardiovascular
interventions
• Continue to advance transcatheter valve
interventions
• Further advance knowledge, education,
standards and research

4. CTO & PCI
• New data and scientific papers in 2020 /2021 year

5. Current challenges & prevention strategies for CTO complications
Expert Review of Cardiovascular Therapy, 19:4, 337-347.

6. Current challenges & prevention strategies for CTO complications
Expert Review of Cardiovascular Therapy, 19:4, 337-347.

7. IVUS-based 3D wiring using the tip detection method
J Am Coll Cardiol Case Rep 2020;2:961–5.

9. Dual Lumen Microcatheters for Recanalization of CTO: A EuroCTO Club Expert Panel Report
EuroIntervention 2021; doi: 10.4244/EIJ-D-21-00291.

10. Definitions and clinical trial design principles for coronary artery
CTO therapies: CTO-ARC consensus recommendations
Circulation. 2021;143:479–500.
Standardized approach to:
 methods,
 end points,
 biomarkers,
 parameters, data & materials,
 processes & procedures,
 evaluations,
 tools & techniques for CTO interventions
A first step toward improved comparability and interpretability of study results, supplying
an increasingly growing body of CTO percutaneous coronary intervention evidence
CTO-ARC consensus recommendations
procedural definitions
end point definitions
clinical trial design principles

12. J Am Coll Cardiol 2021;78:840–853.

13. J Am Coll Cardiol 2021;78:840–853.

14. European Consensus on CTO
by EAPCI & ESC in preparation
for publication in 2022

15. Rui Campante Teles & Radoslaw Parma
Chair & Co-Chair EAPCI Training and Certification Committee (TCC) 2020-2022
EAPCI Certification
of the interventional cardiologist
The CTO field

16. What is EAPCI certification?

17. EAPCI Core Curriculum

19. EAPCI IC Certificate
• Part A: theoretical knowledge
based on PCR-EAPCI Textbook and
ESC Guidelines.
• 100 multiple-choice questions (MCQs).
• Part B: practical skills assessment
• Cathlab pathway: 24-months training
programme with a procedural logbook
• Country Mutual Recognition Process:
reciprocity between national and
EAPCI certifications, in development
2021

20. EAPCI IC Online Exam
Certification Part A – 17 Decemeber 2021

21. Once candidates have passed the exam (part A), they must prove their
practical experience in the field. The access to the e-logbook platform (part
B) is granted to the candidate only after having successfully passed the
written exam.
Pathways defined
1. EAPCI Cath Lab pathway (CLP)
2. EAPCI Country Mutual Recognition Process (CMRP)
Certification Part B

22. EAPCI Certification in CTO ? (draft)
Requirement: EAPCI IC Certification
Mission: to develop a proof of professional excellence for patients and a way to enhance
good cardiovascular percutaneous practice
Objectives:
1. To validate an adequate level of knowledge and practice.
2. To harmonize advanced training.
3. To protect patients from undergoing complex CTO performed by unqualified persons
4. To set a European standard for competency and excellence in this field and to position
EAPCI as the reference entity to develop and implement standards in SHD

23. Once candidates are certified in IC they can apply for the CTO vignette
following a
EAPCI-EuroCTO mutual recognition process
https://www.escardio.org/Education/Career-Development/Certification/Interventional-Cardiology/eapci-certification-for-physicians
EAPCI Certification in CTO ? (draft)

24. Conclusion
The EAPCI aims to reduce the burden of cardiovascular disease through
percutaneous interventions
The EAPCI certification is the live EAPCI Core Curriculum 2020
It aims to validate an adequate level of knowledge and practice, to
harmonize training, to protect patients and to facilitate professional
mobility.
CTO experts may be recognized

25. Perspective in near future:
Consensus document on CTO & specific training
in 2022/2023 year
– collaboration between EAPCI ESC & EuroCTO Club

26. CathLab of XXIc.
Increased impact of imaging
pre-procedural planning
intra-procedural monitoring
post-procedural follow-up

27. „Percutaneous coronary intervention
of a tortuous and complex circumflex lesion using
the robotic CorPath GRX system
– the first Polish experience”
March 2021, Poland
Polish Heart Journal, 2021

28. First robotic PCI in Poland: 23rd March 2021
• Operators:
Prof. Dariusz Dudek
Dr Aleksander Zeliaś

29. Practical utilization of cardiac CT for the success in complex PCI
Cardiovascular Intervention and Therapeutics (2021) 36:178–189

30. Practical utilization of cardiac CT for the success in complex PCI
Cardiovascular Intervention and Therapeutics (2021) 36:178–189

31. Robotic PCI in 2021 and next years :
- Complex PCI
- CTO to reduce radiation exposure
and improve precision of PCI

32. CathLab of XXI century.
Remote Access
…200… 2000 km?
World

33. Catheterization
laboratory in XXI
century
– new state of the art
article on 20 Sept 2021

35. CathLab of XXIc.
STEP 1
image-based
pre-procedural planning
STEP 2
robotic-assisted
procedure
STEP 3
remote procedure
control