Card Tech Minutes 2015.01.06

Review of TAVR Progress

• Adverse TAVR Events: Terms such as hemorrhagic stroke are not defined in the data dictionary. However, adverse events are dynamically updated, by pointing at a source document within the registry. We may need to refer to Traci Connelly for further questions on this point.
• Review of Mapping: Myocardial Infarction has two entries, one that is biomarker positive, the other refers to a more general diagnosis. Should these be clarified?
• Laceration with Tamponade: Has a very broad definition that may include other clinical situations outside of TAVR.
• Is there an LAAO data element listing available? Yes, it is on-line and will be provided.
• TAVR Use Case: Reviewed by clinicians and refined for accuracy.
• Review of History Section: Diabetes is more granular in TVT and SNOMED terms were available for the various manifestations.
• The ACC staff may need to take over development for codes, e.g. Hostile Chest, or Frailty, that do not exist. This may become an 'ACC Only' code. The ACC will develop such an item and submit to SNOMED for these items. This has previously been done for EPRC and CRC, with a 3-4 month turnaround.
• Calculation of Risk Score: Each score may correlate to different procedures. TAVR requires Mitral Valve replacement and Aortic valve replacement scores. It may be valuable to connect with ACC staff off-line.
• Charles Thomas will place documents on the FTP site for review. The RCS-EP document was suggested as a guidance tool. See below:

Table 6.6.5.43-1: Mitral Regurgitation 1.3.6.1.4.1.19376.1.4.1.6.5.215

Code Code System Preferred Name Scope

100001041 ACC NCDR Mild left ventricle hypertrophy AFA

100001042 ACC NCDR Moderate left ventricle hypertrophy AFA

100001045 ACC NCDR Moderate-Severe AFA

100001139 ACC NCDR None (LV hypertrophy) AFA

100001100 ACC NCDR Severe left ventricle hypertrophy AFA

100001111 ACC NCDR Trace AFA