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 2 – Minimum number of procedures required for formation of interventional cardiologists Procedure Yearly minimum for a training center Minimum per trainee in 2 years (first operator) Diagnostic cardiac catheterization 1,500 400 Percutaneous coronary intervention 600 200 candidate must have completed two years of medical residency in Pediatric Cardiology at a service accredited by the CNRM and have completed two years of internship in Pediatric Cardiology in training centers recognized by the SBC or hold the title of specialist in Pediatrics acting in the area of Pediatric Cardiology issued by the AMB/SBC. • During the formation period, the trainee must fulfill the full course load established by the theoretical-practical program. 3.1.5. The Theoretical-Practical Program • The minimum training period is 24 consecutive months, with 30 days of vacation per year, scientific improvement, and participation in congresses and meetings related to the specialization. • The training programmust provide trainees with a complete formation, with mastery of the techniques and knowledge related to cardiovascular interventions. The first year should focus on fundamental training in radiation protection, vascular accesses, diagnostic percutaneous procedures, low complexity coronary interventions, and their complications. The second year should include and focus on training in high complexity coronary interventions, approaches to structural heart disease, extracardiac vascular procedures, and their complications. • The direct participation of the trainee in diagnostic and therapeutic cardiovascular procedures should always take place under preceptor supervision, and all pertinent activities should be duly registered in the current SBHCI database. • Throughout the duration of the training period, the trainee must act as first operator, under supervision, in at least: - 400 diagnostic cardiovascular procedures. - 200 PCI. The minimum training syllabus in hemodynamics and interventional cardiology should comprehend: 3-7 • A review of historical aspects relevant to hemodynamics and interventional cardiology. • Basic concepts of ionizing radiation, image formation, and radiation protection (Annex 1). • Vascular accesses (vascular anatomy; choice and techniques for arterial and venous access in multiple sites [radial/ ulnar, femoral, jugular, transapical, transhepatic, carotid, subclavian/axillary, cavo-aortic]; techniques for obtaining hemostasis; and treatment of vascular complications). • Ultrasound imaging for obtaining vascular access. • Vascular hemostasis devices (indications, benefits, limitations, and complications). • Manometry recordings (critical evaluation of recording quality and its functioning; and analysis of arterial and venous pressure curves in different cardiac cavities and vascular circuits under normal conditions and in pathological situations, including assessment of ventricular diastolic function). • Determination of cardiac output by the Fick principle and the thermodilution method. • To have at least two preceptors, both titular members of the SBHCI for at least five years, with certificates in the area of hemodynamics and interventional cardiology provided by the SBHCI. Each preceptor should perform at least 75 cardiovascular therapeutic interventions annually and demonstrate maintenance of proficiency by sending a record of these interventions to the current SBHCI database. • The program coordinator must be one of the preceptors, and he or she will responsible to the SBHCI for compliance with these recommendations. • Perform at least 1,500 diagnostic cardiac catheterizations annually, proven by a declaration signed by the technician responsible for the service. • Perform cardiovascular interventions, with at least 600 PCI yearly, proven by a declaration signed by the technician responsible for the service. • Send the records of all cardiovascular interventions performed annually to the current SBHCI database. • Follow the theoretical-practical program recommended in this Position Paper. • The number of openings made available to candidates per team per year must comply with the following limits: for the minimum requisite of 600 annual angioplasties, up to two openings; for each increment of 200 PCI, one opening may be added. It is necessary that there be a ratio of one preceptor per trainee (Chart 2). 3.1.4. Trainees The prerequisites and obligations of trainees include a degree in Cardiology and full-time dedication to the training program, in addition to the following: 3 • Be duly registered with the Regional Council of Medicine (Conselho Regional de Medicina – CRM) of the state where the training center is located. • Have completed two years of medical residency in Cardiology at a service accredited by the National Medical Residency Commission (Comissão Nacional de Residência Médica – CNRM); have completed two years of internship in Cardiology in training centers recognized by the SBC or hold the title of specialist in Cardiology issued by the Brazilian Medical Association (Associação Médica Brasileira – AMB)/SBC. • For the interventional cardiology for congenital heart diseases program, in place of the previous items, the 143