Protocols for Regional Weekly MDT
Background
The Aortic Dissection Toolkit recommends MDT led management of aortic dissection and encourages regional networking. Within the North-west, North Wales and Isle of Man, acute aortic dissection (Type A and B) are managed by Blackpool/Preston, Manchester and Liverpool.
Regional weekly distal aortic MDT
The Northwest Regional Distal Aortic MDT runs via Teams on a Wednesday morning from 08.15 to 9.00 on a weekly basis. It is coordinated through the LHCH Aortic MDT coordinators ([email protected] ).
This is to discuss all regional acute dissections as well as selected elective arch and thoracoabdominal aneurysms. It includes referrals from within the North West, North Wales, IOM and further afield in the North of England.
Standard Operating Policy
a) Patient criteria for discussion:
- All acute and sub-acute Type B aortic dissection patients within the month, before or after treatment.
- All operated acute Type A aortic dissections once predischarge CT is performed.
- Any patients with chronic thoracoabdominal aortic disease needing treatment.
b) Each centre will be responsible for presenting their patients’ history, relevant investigations (ie echo, PFTs and coronary angiograms) and aortic imaging. For imaging presentation, formal radiology input would be expected from the relevant centre.
c) All acute cases will be discussed up front in each MDT followed by the elective work.
d) The MDT cannot address detailed technical nuances on treatment modalities. Team members are encouraged to discuss these outside the meeting (before and/or after) within their centre or, where appropriate, with members of other centres.
e) Discussions within the MDT will cover the broad-brush strokes of treatment options.
f) Patients will be registered for the MDT via e-mail to the Aortic MDT Coordinator giving name, DOB and NHS number with a brief synopsis.
g) Whenever possible, teams are encouraged to propose a management strategy for endorsement by the MDT.
h) A letter will be generated for each patient and shared with the consultant who registered the patient, describing the outcome.
i) Ultimate responsibility and governance for patients remains with the primary centre.
For patients referred to the Liverpool Cardiovascular Service Clinic at LHCH, either as a result of the MDT discussion, or along elective pathways from units outside of the Toolkit Network, a minimum data set is requested and the MDT proforma can be obtained from the Aortic Coordinator.
