[Percutaneous coronary interventions without on-site cardiac surgical backup]

Percutaneous coronary interventions are now, three decades after the first balloon angioplasty of the coronary arteries, safe, effective, and most commonly applied method of myocardial revascularization. The first percutaneous coronary intervention without "on-site" cardiac surgery began at the beginning of the nineties of the twentieth century, thanks to the improvement of techniques and materials used for these procedures, as well as the need to make available to citizens in remote areas modern and effective therapy. However, today, after nearly twenty years of application of percutaneous coronary interventions in facilities without cardiac surgery this issue remains controversial and unresolved. So despite the existence of a large number of interventional cardiology centers without "on-site" cardiac surgery in a large number of countries in which they performed a significant number of elective and primary interventions, the official guidelines of the associations for percutaneous coronary interventions still does not recommend implementation of interventions without the existence of "on -site" cardiac surgery. But, recently the focus shifts from the questions about presence of "on-site" cardiac surgery in the direction of defining criteria for performing percutaneous coronary interventions according to the highest standards regardless of the existence of "on-site" cardiac surgical backup. This review article gives the current view on current attitudes about the organization and implementation of percutaneous coronary interventions in facilities without cardiac surgical backup.