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[Cardiac interventions in Switzerland in 1994]
1Departement Innere Medizin, Universitätsklinik, Inselspital, Bern.
Insights
Cardiac interventional procedures in Switzerland show a rise in coronary angioplasty and stent use. Ad hoc angioplasty is common, while other devices decline. Cardiac surgery is stable.
Area of Science:
- Cardiology
- Interventional Cardiology
- Cardiac Surgery
Background:
- A survey of cardiac procedures in Swiss centers has been conducted annually since 1987.
- The 1994 survey continued this data collection among 25 Swiss centers.
Purpose of the Study:
- To analyze trends in cardiac invasive, interventional, and surgical procedures in Switzerland in 1994.
- To present data by individual center and sector (university, private, public).
Main Methods:
- Detailed questionnaire distributed to 25 Swiss centers.
- Data collected on cardiac invasive, interventional, and surgical procedures performed in 1994.
Main Results:
- Coronary angioplasty use continues to increase, driven by simpler cases; multivessel angioplasty remains low.
- Over half of angioplasties were performed ad hoc (immediately after coronary angiography).
- Coronary stent use has risen sharply; other devices like atherectomy and rotablation have declined. PTCA for infarction is rare. Coronary ultrasound is the main diagnostic tool. Cardiac surgery is stable. Valvuloplasty is rare. Catheter closure of shunt defects is routine.
Conclusions:
- Coronary angioplasty and stent implantation are increasingly utilized, with a trend towards ad hoc procedures.
- Interventional catheter procedures are concentrated in university centers, while coronary artery bypass graft interventions are more common in private institutions.
Abstract:
As in the previous seven years, a survey of cardiac invasive, interventional and surgical procedures among the 25 Swiss centers was carried out in 1994 by a detailed questionnaire. The resulting data are presented per individual center and per university, private or public sector. The outstanding findings of the 1994 survey are: There is an ongoing increase in the use of coronary angioplasty. The rapid evolution of coronary angioplasty is predominantly due to an extension of indications towards simple cases since the percentage of multivessel angioplasties has remained low. More than half of all angioplasties have been performed immediately after the respective coronary angiography (ad hoc angioplasty). The use of coronary stents has increased steeply over the past three years. Other new devices like directional coronary atherectomy, rotablation and transluminal extraction have lost further ground. PTCA for ongoing infarction has remained exceptional, probably due to logistical problems. Among the diagnostic tools, only coronary ultrasound has been used regularly. Coronary as well as non-coronary surgery seem to plateau. Percutaneous balloon valvuloplasties remained rather rare interventions. Catheter closure of congenital shunt defects has joined the routine interventional procedures. The majority of interventional catheter procedures have been performed at the five university centers whereas the majority of coronary artery bypass graft interventions have been carried out at private institutions.