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Outpatient cardiac catheterizations: analysis of patients requiring admission
S Pink1, L Fiutowski, R E Gianelly
1Department of Cardiology, Baystate Medical Center, Springfield, Massachusetts 01199.
Insights
Outpatient cardiac catheterization is a safe procedure with a low complication rate. Most admissions were for urgent bypass surgery in patients with significant coronary artery blockages.
Area of Science:
- Cardiology
- Interventional Cardiology
- Vascular Surgery
Background:
- Outpatient cardiac catheterization is increasingly common.
- Assessing the safety and outcomes of this procedure is crucial.
Purpose of the Study:
- To review outcomes of the first 1,000 outpatient cardiac catheterizations.
- To identify complications and reasons for hospitalization.
Main Methods:
- Retrospective review of 1,000 outpatient cardiac catheterizations.
- Percutaneous femoral artery approach using #8F catheters was predominant.
Main Results:
- No deaths occurred.
- Major complications included myocardial infarction (2) and cerebral emboli (4).
- 3.9% of patients required admission, most commonly for urgent bypass surgery due to significant left main coronary stenosis.
Conclusions:
- Outpatient cardiac catheterization is a safe procedure.
- Careful patient selection is important, especially for those with severe coronary artery disease.
- Admissions are infrequent and often related to necessary revascularization procedures.
Abstract:
The purpose of this study was to review the results of the first 1,000 outpatient cardiac catheterizations performed at our hospital with special emphasis on patients who were hospitalized. Nearly all patients had percutaneous femoral artery catheterization using #8F catheters. There were no deaths. The major complications included two myocardial infarctions and four cerebral emboli. Surgery on the femoral artery was required in 2 patients (1 occlusion and 1 pseudoaneurysm), 7 patients developed unstable angina without subsequent infarction, and 4 patients had ventricular tachycardia or fibrillation. Complications requiring admission were found in 39 patients. Another 59 were admitted, 51 for revascularization procedures. Of the latter 51 patients, 27 had main left coronary stenosis of 50% of greater. We have found outpatient catheterization to be a safe procedure. Complications requiring admission occurred in 3.9% of the patients. The most common reason for admission was to perform urgent bypass surgery in patients with main left coronary stenosis in excess of 50%.