Percutaneous coronary intervention without on-site cardiac surgery: the first one thousand patients

• Published in: Orvosi hetilap Vol. 146; no. 31; p. 1615
• Main Authors: Voith, László, Vecsey, Tibor, Major, László, Zsoldos, András, Nagybaczoni, Béla, Andrássy, Péter, Zámolyi, Károly, Tomcsańyi, Jańos
• Format: Journal Article
• Language: Hungarian
• Published: Hungary 31.07.2005
• Subjects: Adult; Aged; Angina Pectoris - therapy; Angina, Unstable - therapy; Angioplasty, Balloon, Coronary - mortality; Coronary Disease - mortality; Coronary Disease - pathology; Coronary Disease - physiopathology; Coronary Disease - therapy; Female; Heart Conduction System - physiopathology; Humans; Male; Middle Aged; Myocardial Infarction - therapy; Retrospective Studies; Stents; Treatment Outcome
• ISSN: 0030-6002

At the two hospitals, first percutaneous coronary intervention was performed on 1031 patients (700 male and 331 female, average age 59.8 +/- 15.1 years) between July 2000 and June 2002. The indications were: stable effort angina 679 (65.8%), unstable angina and non-ST elevation myocardial infarction 267 (26.0%), ST elevation myocardial infarction 85 (8.2%). Single vessel dilatation was performed on 906 (87.9%), double and triple vessel on 125 (12.1%) pts in 1170 vessels (1145 native, 24 saphenous vein and 1 mammary artery graft) and in 1372 stenoses. During the interventions, 1043 stents were implanted in 797 pts, average 1.3/pt. The intervention was clinically successful in 950 (92.1%) and unsuccessful in 81 (7.9%) pts. In most of cases, the lack of success was a result of ineffective recanalisation. 65 major adverse cardiac events occurred in 35 (3.4%) pts (acute redilatation 20 (1.9%), acute surgery 4 (0.4%), acute myocardial infarction 34 (3.3%) and fatal outcome 7 (0.7%). Fatal outcome occurred in the group of stable angina 1 (0.1%), in the group of unstable angina and non-ST elevation myocardial infarction 4 (1.5%), in the group of ST elevation myocardial infarction 2 (2.4%). Within one year, 228 (22.1%) repeated dilatations were performed because of chronic restenosis. The results suggest that the moderate risk interventions can be performed with satisfactory result and average risk even without in-hospital cardiac surgery. High-risk interventions are still to be performed in institutes without on-site surgery.