Complex patients and difficult decisions: how should I treat?

It may be the last day of EuroPCR’09 but Room1 will be highly active this morning for the ‘How should I treat?’ session; the only one to be held in Room 1, an indication of its relevance and importance to the Course programme. The three main issues discussed today are multivessel disease, left main stenosis and aortic stenosis.

The session begins and ends with live cases from Singapore and between these cases there will be intense discussion amongst the well respected panel for each case. The session format is such that a ‘real-life’ case is presented to the panel. Two members of the panel then discuss how they would treat this patient and the first presenter then responds with how the patient was treated by the operator. The panel will then discuss the various options presented with the aim of reaching a consensus on the way forward for similar cases in the future, or establishing a "best-practice" formula.

The key to the final discussion in each case is the application of evidence-based medicine. In most cases we can expect there will be some disagreement between the panel but the outcome in each case will be a very constructive dialogue that leads to a clear and concise recommendation from the panel as to the best way forward in each case.

One of the most exciting things about the "How should I treat?" session today is that there will be a multidisciplinary approach to each case with both interventional cardiologists and surgical cardiologists providing input. This provides the panel and the audience with the best-possible overview of treatment options and the best approach, highlighting the fact that while the interventionalist acts as a gatekeeper for the surgeon, it is necessary to include the surgeon in decision-making. This approach not only benefits the team but more importantly shows a patient-centred approach. Don’t miss it, your patients will thank you!