Cardiac catheterization experience in hospitals without cardiovascular surgery programs

In order to study the cardiac catheterization experience in hospitals without cardiovascular surgery programs, data was collected from all 8 Washington "satellite" laboratories over a 5-year period. There were 5 deaths (0.13%) during the 3878 coronary arteriography procedures. Of the 5, 4 had severe left main coronary artery lesions. Of these patients, 2 died during the 24-hour follow-up period after an uncomplicated study. This mortality rate is remarkably good considering that the 5-year period includes the early experience of 7 laboratories. There were 7 myocardial infarctions (0.18%) and 6 strokes (0.15%). The average number of coronary arteriograms done per angiographer during 1976 was 65. The experience of the Washington State "satellite" cardiac catheterization laboratories proves that the immediate availability of cardiovascular surgery and large case loads per angiographer are not necessary in order to safely perform cardiac catheterization and coronary arteriographic studies. Additional studies should be undertaken to determine the appropriate distribution of cardiac diagnostic facilities.