Bijzondere interventies aan het hart - Gezondheidsraad

all the more desirable that a cardiac surgeon should be available, for both dialogue
and surgery.
Secondly, developments in the field of cardiac arrhythmias (particularly in
ICD implantation) actually require frequent consultation between the interventional
cardiologist, the electrophysiologist, and the heart surgeon. This should
result in selecting the best possible treatment strategy for the individual patient.
A similar development can be seen in patients with chronic heart failure, where a
range of treatment options is available. The same is true of patients with congenital
cardiac defects who also require further procedures during adulthood. Furthermore,
there is an ever increasing range of opportunities and situations in
which the intervention involves both the heart surgeon and the interventional cardiologist.
The logistics associated with integrated interventions of this kind are
often very complex in nature. This requires prudent multidisciplinary consultations,
and carefully tailored planning.
For these reasons, there is a growing need for heart patients to be treated in
centres that are able and have the resources to provide all complex forms of care.
Accordingly, integrated care in specialised centres should also become a major
focal point in the policy. Environments such as this allow for close collaboration
between those representing the various disciplines involved. It also allows them
to fine-tune the details of the treatment with the relevant paramedical staff. This
enables treatment to be better tailored to the “disease life-cycle” affecting individual
heart patients. Rather than following a fixed procedure, this approach provides
for an optimal treatment strategy in each stage of the disease process. This
also means that patients themselves are involved in all aspects of the process.
Furthermore, they are kept fully informed about the full range of treatment
options available, including their advantages and drawbacks.
4 Organise cardiac care on a regional basis
As stated, in centres for the treatment of cardiac patients, close collaboration
between the various specialists and specialisms involved is both desirable and
necessary. Accordingly, care institutions will need to be better attuned to one
another in the near future, in terms of their contributions to the treatment of heart
patients within a single region. This certainly applies to the provision of care to
patients suffering from acute infarctions. Situations of this kind demand optimum
teamwork between PCI centres, other hospitals with acute care facilities,
GPs, and ambulance services. A regional approach of this kind must also involve
well organised, close collaboration between PCI centres without heart surgery
facilities of their own, and heart surgery centres that will provide the requisite
Executive summary 33