MedicalResearch.com Interview with:
Adam Skolnick, MD
Associate professor of medicine
NYU Langone Medical Center
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: I am privileged to serve on the ACC Program Planning Committee and helped to design this important session that seeks to determine the line between when a cardiovascular procedure is high risk and when it is futile. I am co-chairing the session with the incoming chair of the section on Geriatric Cardiology for the ACC, Dr. Karen Alexander from Duke.
We are practicing medicine at one of the most extraordinary times when there are so many devices and procedures to prolong and improve quality of life. It is critical to assess a patient’s goals of care for a given intervention. In some patients, particularly those who are multiple degenerative chronic conditions, are frail and/or have cognitive impairment it is difficult to know when a given procedure multiple medical conditions will achieve a patient’s goals. When is a procedure high risk, and when is it simply futile? This is the fine line upon which many cardiologists often find themselves.
The speakers present case examples of high risk patients considering TAVI, high risk PCI or CABG and mechanical support devices and with interaction from the audience work through when each procedure is high risk and when it is unlikely to achieve a patient’s goals of care. We also have a dedicated talk on high risk procedures in patients with cognitive impairment, such as advanced dementia.