Structural Heart Procedure Templates

Structural Heart Procedure Templates (Current)
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The templates that comprise the Structural Heart Procedure Templates Report are interconnected as in Figure A-10c.

Figure A-10c. Structural Heart Procedure Template Structure

TID 5320 Structural Heart Measurement Report

This template forms the top of a content tree that allows a device to describe the results of periprocedural imaging associated with minimally invasive structural heart procedures. It may be used during pre-operative assessment, intraprocedural assessment, or follow-up. While it mirrors the Simplified Echo Procedure Report, it is designed for measurements taken in one of several modalities, i.e., Echo, CT and MR.

This template does not include an Image Library. Image Content Items in the Echo Measurement templates (for example to indicate Source of Measurement) shall be included with by-value relationships, not with by-reference relationships.

Measurements in this template (except for the Wall Motion Analysis) are collected into one of three containers, each with a specific sub-template and constraints appropriate to the purpose of the container.

Pre-coordinated Measurements (many taken from the STS/ACC TVT Registry).
Post-coordinated Measurements
Adhoc Measurements

Type:: Non-Extensible
Order:: Significant
Root:: Yes

Table TID 5320. Structural Heart Measurement Report

	NL	Rel with Parent	VT	Concept Name	VM	Req Type	Value Set Constraint
1			CONTAINER	DCID 12344 “Structural Heart Measurement Report Document Title”	1	M
2	>	HAS CONCEPT MOD	INCLUDE	DTID 1204 “Language of Content Item and Descendants”	1	U
3	>	HAS OBS CONTEXT	INCLUDE	DTID 1001 “Observation Context”	1	M
4	>	CONTAINS	CONTAINER	DT (55111-9, LN, "Current Procedure Descriptions")	1	U
5	>>	CONTAINS	CODE	DT (121139, DCM, "Modality")	1	M	Shall be a code derived from the Value of Modality (0008,0060) in the Image Instances.
6	>>	CONTAINS	TEXT	DT (125203, DCM, "Acquisition Protocol")	1	U
7	>>	CONTAINS	INCLUDE	DTID 8131 “Medications and Mixture Medications”	1-n	U	$DrugAdministered = BCID 12342 “Bradycardiac Agent”
8	>>	CONTAINS	NUM	EV (8867-4, LN, "Heart Rate")	1	U	UNITS = DT ({H.B.}/min, UCUM, "BPM")
9	>	CONTAINS	CONTAINER	EV (18785-6, LN, "Indications for Procedure")	1	U
10	>>	CONTAINS	CODE	EV (118797008, SCT, "Heart Procedure")	1	M	BCID 12331 “Structural Heart Procedure”
11	>>>	HAS CONCEPT MOD	CODE	EV (121071, DCM, "Finding")	1-n	U	DCID 12341 “Indication for Structural Heart Procedure”
12	>>>	HAS CONCEPT MOD	TEXT	EV (121071, DCM, "Finding")	1	U
13	>>>	HAS CONCEPT MOD	INCLUDE	DTID 3831 “Medical Device Use”	1-n	U	$Device = BCID 12332 “Structural Heart Device”
14	>	CONTAINS	INCLUDE	DTID 3602 “Cardiovascular Patient Characteristics”	1	U
15	>	CONTAINS	CONTAINER	EV (125301, DCM, "Pre-coordinated Measurements")	1	M
16	>>	CONTAINS	INCLUDE	DTID 5301 “Pre-coordinated Cardiac Measurement”	1-n	U	$Measurement = DCID 12333 “Structural Heart Measurement” $Preferred = DCID 12301 “Measurement Selection Reason”
17	>	CONTAINS	CONTAINER	EV (125302, DCM, "Post-coordinated Measurements")	1	M
18	>>	CONTAINS	INCLUDE	DTID 5302 “Post-coordinated Cardiac Measurement”	1-n	U	$AnatomicSite = DCID 12339 “Structural Heart Procedure Anatomic Site” $Preferred = DCID 12301 “Measurement Selection Reason”
19	>	CONTAINS	CONTAINER	EV (125303, DCM, "Adhoc Measurements")	1	M
20	>>	CONTAINS	INCLUDE	DTID 5303 “Adhoc Measurement”	1-n	U	$Property = DCID 12304 “Cardiovascular Measured Property”
21	>	CONTAINS	INCLUDE	DTID 5204 “Wall Motion Analysis”	1-n	U
22	>	CONTAINS	CONTAINER	EV (C0034375, UMLS, "Qualitative Evaluations")	1	U
23	>>	CONTAINS	CODE	BCID 12345 “Cardiac Structure Calcification Qualitative Evaluation”	1-n	M	BCID 3716 “Severity”

Content Item Descriptions

Row 4	This container describes the periprocedural imaging during which the measurements were taken.
Row 6	User-defined type of clinical acquisition protocol for creating images or image-derived measurements. May be taken from Protocol Name (0018,1030) or from Performed Procedure Step Description (0040,0254).
Row 7	Bradycardic medications administered to lower the heart rate during the imaging study.
Row 8	The nominal heart rate immediately prior to the start of image acquisition. If a bradycardic agent is administered, this is measured after its administration.
Row 9	This container provides details regarding the structural heart surgical procedure that is supported by the periprocedural imaging procedure described in Row 4.
Row 12	A text string containing one or more sentences describing one or more indications, possibly with additional comments from the physician or technologist.
Row 16	These are measurements from a standardized list of pre-coordinated codes. Measurements that do not correspond to the full semantics of one of the pre-coordinated codes in the Value Set Constraint can likely be encoded in Row 18 instead. Multiple instances of the same measurement code may be present in the container. Each instance represents a different sample or derivation. This template makes no requirement that any or all samples be sent. For example, a mean value of all the samples of a given measurement could be sent without sending all or any of the samples from which the mean was calculated. Device configuration and/or operator interactions determine what measurements are sent.
Row 18	These are measurements that can be encoded using a standardized structure of post-coordinated codes. Measurements that correspond to the full semantics of one of the pre-coordinated codes in Row 16 instead. $Measurement shall be provided, but is not constrained to a CID. Multiple instances of the same measurement code may be present in the container. Each instance represents a different sample or derivation. CID 12339 “Structural Heart Procedure Anatomic Site” contains concepts appropriate for mapping STS/ACC TVT Registry measurements. It is recommended that these locations be used unless a more detailed location is necessary. This template makes no requirement that any or all samples be sent. For example, a mean value of all the samples of a given measurement could be sent without sending all or any of the samples from which the mean was calculated. Device configuration and/or operator interactions determine what measurements are sent.
Row 19	These are adhoc measurements encoded with minimal semantics. Row 18 can be used to encode measurements with more complete semantics. $Units shall be provided, but is not constrained to a CID. Device configuration and/or operator interactions determine what measurements are sent.
Row 22	These are name-value pairs to encode qualitative assessments of cardiac structure calcification severity.

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