ABC | Volume 114, Nº1, January 2019

Statement Position Statement of the Brazilian Cardiology Society and the Brazilian Society of Hemodynamics and Interventional Cardiology on Training Centers and Professional Certification in Hemodynamics and Interventional Cardiology – 2020 Arq Bras Cardiol. 2020; 114(1):137-193 Chart 1 – Necessary requirements for structural constitution of a training center catheterization laboratories 1. A radiological device, adequately fixed to the ground or ceiling, and a motorized C-arm system 2. Architecture that allows for axial projections with 40º angulation and oblique projections with 90º angulation, by electronic movement 3. An examination table with capacity to support patients weighing up to 200 kg, plus 100 kg imposed during reanimation maneuvers 4. A high-voltage X-ray generator with 80 kW minimum power, for rapid radiation emission, sufficient to obtain image contrast and sharpness 5. An X-ray tube with minimal thermal capacity of 1,700,000 HU 6. Pulsed fluoroscopy with rates of at least 30/15 pulses per second 7. An image intensifier with the highest possible conversion factor or a flat-panel digital system 8. High-quality digital imaging with a matrix of at least 512 × 512 × 8 bits at 30 frames per second 9. Long-term (20-year) digital archiving in DICOM format 10. Polygraph with a record of at least three electrocardiogram and two pressure channels 11. Contrast injection pump 12. An anticoagulation monitoring device by measurement of activated coagulation time 13. Pulse oximetry 14. Equipment for measurement of cardiac output by thermodilution 15. Material for cardiorespiratory resuscitation and external pacemaker/defibrillator 16. Intracardiac lead and temporary pacemaker generator 17. Radiation protection equipment 3. Norms for Establishing Hemodynamics and Interventional Cardiology Training Centers The SBHCI has always been vigilant regarding the formation of new professionals in the area, elaborating norms that guarantee the quality of services provided at diverse hospitals in diverse communities. These position papers, which are the result of consensus between members of the commission who participated in their elaboration, are intended to update the criteria for capacitating training centers acting in the area of interventional cardiology. Existing centers and centers that may be established in the future must comply with the following criteria in order to maintain or apply for accreditation as SBHCI Hemodynamics and Interventional Cardiology Training Centers. 3 3.1. Basic Requirements 3.1.1. Hospitals (Institutions) A hospital which is a candidate to become a Training Center must apply to the SBHCI, and it must meet the following essential composition and resource requirements: • Hemodynamics and interventional cardiology laboratory. • Active cardiovascular surgery service. • Intensive therapy unit or coronary unit. • Clinical analysis laboratory. • Hemotherapy service. • Imaging services, comprising radiology, transthoracic and transesophageal Doppler echocardiography, preferably with 3-D reconstruction, Doppler ultrasound, computerized tomography (CT) and/or magnetic resonance (MR), digestive endoscopy. • Hemodialysis service. • Clinical specialties (cardiology, radiology, nephrology, neurology, gastroenterology, pneumology, hematology, and anesthesiology). • Ventricular assist devices. 3.1.2. Hemodynamics Laboratories To the extent that the spectrum of interventional procedures expands, in conjunction with the complexity of “old” and new procedures, catheterization laboratories must have equipment and instruments that are compatible with this new working scenario, especially in training centers. The supplies necessary for catheterization laboratories to function and the role of nurses, radiology technicians, and other members of the interventional cardiology teams are described in the latest guidelines on professional quality, and they are in consonance with current practice. 2 The necessary requirements for structural constitution of a training center catheterization laboratories are described in Chart 1. For Training Centers that utilize more than one catheterization laboratories in different hospitals, it is mandatory for each unit to comply with the basic minimum requirements listed in this Position Paper. 3.1.3. Medical Teams Medical teams must be made up of preceptors and a coordinator, provided that they meet the following requirements: 142