SASCI Newsletter: AfricaPCR, Annual General Meeting and more

  • May 01, 2013

AfricaPCR, Annual General Meeting and more

I would like to start by thanking all members who attended the second AfricaPCR programme in Cape Town and those who made the effort to attend the Annual General Meeting. Thank you to the Executive Committee Members who were willing to serve another term and were re-elected (with a few portfolio changes). Your active contribution is the key to SASCI’s functioning.

  • Farrel Hellig (President, AfricaPCR, International congresses)
  • Dave Kettles (Vice President, Guidance)
  • Cobus Badenhorst (Treasurer and SHARE)
  • Adie Horak (Secretary)
  • Graham Cassel (ex-Officio President)
  • Sajidah Khan (Educational including ESC eLearning Platform and AfricaPCR)
  • Mpiko Ntsekhe (Academic, AfricaPCR)
  • Chris Zambakides (Academic, CTO)
  • Len Steingo (Coding, Funders and Website)
  • Mark Abelson (Coding and Funders, LAA Closure)
  • Jean Vorster (SA Heart Congress 2014 Scientific Programme)

Gill Longano and Liezl le Grange remain for ISCAP and industry representatives continuing into 2014 are: Tracey du Preez, Craig Goodburn and Hans Buyl.

Graham Cassel tabled the following at the AGM: “SASCI is supported by a great Exco and support team. The previous year was a challenging one and the Exco members would like to congratulate Farrel on a sterling job done thus far. It is a privilege to support him on the Exco”.

Our Associated Members Group (ISCAP) continues its high activity levels and we will continue to support them as best we can. Please see a complete news review within this newsletter.

The Interim Financial Statements were presented by George Nel at the AGM and the directors were authorised to sign the financial statements when available. SASCI finances continue to look healthy and funding is available to pursue programmes to achieve our constitutional objectives.

I would like to thank our corporate supports for their continued and unwavering support over the past 10 years. They are Amayeza, Angio Quip, Aspen, AstraZeneca, Baroque, B Braun, Boehringer-Ingelheim, Boston Scientific, Cipla Medpro, Cordis, Disa Vascular, Edwards, Medtronic, Paragmed, Pharma Dynamics, Surgical Innovations, Torque Medical, Viking, Volcano and Winthrop. We are looking forward to working in collaboration with you in 2013.

AfricaPCR Interactive Case Corner and a full-day AfricaPCR programme was embedded in the World Congress of Paediatric Cardiology and Cardiac Surgery 2013 held in Cape Town in February. For the Interactive Case Corner, 28 case submissions were received from all over the world (Africa including South Africa, Asia, Europe, Middle-East and South America) and a broad range of interventional material was discussed. 

The main AfricaPCR Program (22 February) included a “How should I Treat” session on pericardial disease and two “Learning the Technique” sessions on Balloon Mitral Valvuloplasty and TAVI. The Friday programme was well attended by more than 150 delegates and feedback was extremely positive.

I would like to thank everyone who contributed to these meetings and believe that we have established a firm base for the planned two-day AfricaPCR Course in 2014.

AfricaPCR 2014 will take place from 21 – 23 March 2014 In Cape Town. SASCI’s AGM will in future be held at AfricaPCR (if the congress is held in South Africa) otherwise at the SA Heart Congress. SASCI will continue to support SA Heart Congresses and contribute to the scientific programme.

Two SASCI Breakfast Symposia were also hosted on 21 and 22 February to bolster adult coronary content during the World Congress. 

Adie Horak was the SASCI programme convener with able assistance from Dave Kettles and Mark Abelson. The programme had a “PCR - How Should I treat” format. Both sessions were extremely well attended and the subject matter "Case-based Discussions: Complications of coronary intervention" and "Case-based Discussions: Interventions in coronary lesion subsets" led to vigorous discussion with active audience participation.

Other noteworthy activities 

SASCI and Tom Mabin’s TAVI Appeal Hearing took place on 15 March 2013 in Pretoria after the Council for Medical Schemes (CMS) initially ruled “in favour” of Medshield not funding TAVI based on the funder's own rule exclusion.

The ruling of the appeal committee was received in April and is in our (patient's) favour. The Medical Aid is directed to pay for the TAVI procedure in full and it is viewed that the Medical Aid cannot exclude therapy based only on their own rules (even if these are approved by CMS).

This is a landmark ruling but as with legal processes the next step could involve an appeal by the Medical Aid (to be lodged within the next two months, if at all) to the CMS Appeal Board which could add an additional 12 months to the process. The patient, however, could enforce the ruling and action the judgement (forcing the Medical Aid to fund the procedure).

This process is extremely important as the CMS is mandated to look after the interests of the medical aid member and protect their rights. SASCI is ensuring that this happens. Please go to www.medicalschemes.com if you need more information on CMS or refer your medical aid patients if needed.

A SASCI delegation consisting of Len Steingo, Graham Cassel, David Jankelow and George Nel (with Farrel Hellig offering his apologies – stuck in the lab) met with Discovery Health on 25 April to discuss pertinent issues (including TAVI, Coding, Bioresorbable Scaffold, Cardiac CT Scan) as well as alternate reimbursement models (to be developed to better reflect the changing face of interventional cardiology). This meeting has identified definitive areas requiring collaboration and will be reported on as these unfold in the near future.

Educational for members and fellows

French-Reunion-South African 2013 took place from 17 – 19 April 2013 in Bordeaux, France. Tom Mabin once again represented SASCI on the organising committee and a high-quality programme with exceptional faculty has been assembled. This is the final FRSA SASCI will officially be involved in.

The EuroPCR Congress will take place from 21 – 24 May in Paris, France. During EuroPCR 2013 SASCI will once again have a high visibility with a joint “How should I treat?” session with Croatia, Cyprus and Serbian societies as well as a joint session with Polish society on TAVI.

In addition SASCI will participate in a new learning programme based on presentation of “complication cases” chaired by Graham Cassel. Live cases have also been finalised for the main PCR auditorium from Farrel Hellig’s unit at Sunninghill.

Visiting Professor Programme

SASCI approached the renowned Prof Tony Gershlick of the University of Leicester in the UK to visit South Africa early in 2014 as our visiting professor. He is positively considering this invitation. Prof David Holmes is a possibility either late in 2014 or early 2015. Medtronic is thanked for their continued support of this programme.

RC Fraser

Dr Aine Mugabi, the 2012 recipient of the RC Fraser International Fellowship in Cardiovascular Intervention Award will travel to Dr Martyn Thomas (Consultant Cardiologist & Clinical Director for Cardiovascular Services) unit at  Guy's & St Thomas' Hospital, London for one month in 2013 where he will have the opportunity to expand his knowledge and further his abilities.

The 2013 award recipient was announced at the recent SASCI Fellows Programme. Ahmed Vachiat from Wits University (Johannesburg Hospital) is the 2013 Fellowship award recipient. This award is annually sponsored by Boston Scientific.

The 8th Annual SASCI Fellows programme took place on the weekend of 26 – 28 April 2013 in Cape Town at the Lagoon Beach Hotel with Dr Mark Abelson as programme director and faculty members Jean Vorster, Dave Kettles, Tom Mabin, Chris Zambakides and Farrel Hellig.

We had 32 South African Fellows attending as well as a delegation of nine from Mauritius and two from Kenya. In total more than 70 delegates attended this truly African learning initiative and our biggest Fellows Programme to date. 

The programme was based on case reviews and canned cases which led to active and lively educational discussions. The opportunity was also given to Santosh Reebye and Udhay Ramjutun from Mauritius to present cases. Thank you to our corporate supporters who made this meeting possible: Aspen, AstraZeneca, Angio Quip, Baroque, B Braun, Boston, Disa Vascular, Edwards, Medtronic, Paragmed, Pharma Dynamic, Torque Medical and Volcano.

Sajidah Khan will be the South African national co-ordinator for the new ESC eLearning Platform. This programme will focus on web-based Fellows training, offering training in six sub-specialties with the first module (interventional cardiology) launched early in 2013. Participants need to become members of the EAPCI association and a fee of EUR120 per calendar year applies. The duration of the EAPCI Learning Programme is two years.

SAMA CPT Coding

Mark Abelson and Len Steingo have done a sterling job of submitting new codes to SAMA this year. Due to their hard work and excellent preparation (and representation by Len on the day) most submissions were accepted. These are the first cardiovascular codes in many years to be included in the SAMA Doctor Billing Manual (2014).

The following has transpired:

  • Interpretation items 1286 and 1287 – SASCI requested that the code interpretation should be changed from “per vessel” to “per lesion” and this has been approved.
  • Renal Denervation (RDN) – A new dedicated code will be added to the 2014 DBM. The description will indicate that the item is applicable for each renal artery.
  • Fractional Flow Reserve (FFR) – Two dedicated add-on codes have been granted. These will be codes to be added, per vessel, to the primary procedure code. This will be charged equivalent to IVUS.
  • Transcatheter closure of the left atrial appendage (LLA) – A new dedicated code will be added.
  • Trans-aortic Valve Implantation (TAVI) – A dedicated code will be added. However, as there are few TAVI  codes in the CPT® structure, further attention will be given to include a range of TAVI codes, not only one.
  • Vascular Closure Device – A dedicated code was NOT granted as closure is seen as an inherent part of the procedure.
  • Percutaneous coronary angioplasty using a drug eluting balloon (DEB) – A dedicated code was NOT granted but the description of items 5058 – 5068 will be revised to include the use of a drug eluting balloon. This will be charged equivalent to a stent.
  • Z-codes – Are problematic as some medical aids use this to justify non-payment. SASCI approached SAMA to understand the reasons for Z-codes and the process to be followed to get Z-codes removed. SAMA confirmed that the Z-coding should NOT be used to motivate non-payment as the code only indicates that a code is new within the coding structure. The Z-code is removed when utilisation data is received by SAMA. SASCI will secure utilisation data for the following codes 1272 (coronary sinus lead implantation) and 1274 (aspiration of thrombus from coronary artery or saphenous vein bypass graft). These codes are therefore already accepted but need to be removed from the Z-coding status.

SASCI will engage the funders in 2013 to secure the use of these codes and possible funding for these new codes in 2014.

A dedicate CTO portfolio within the SASCI Exco has been created with the aim of creating awareness and improving CTO procedure outcomes through education and training. CTO is a lengthy procedure which calls for patience and precision. If members are interested in learning these procedures they can contact Chris Zambakides and Farrel Hellig.

Crossroads is hosting a theoretical workshop in mid-2013 on CTOs. A CTO workshop is being considered for 2014 (which will be planned and run through the SASCI office after Exco approval).

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