[Cardiac interventions in Switzerland]

For the year 1995, as for the previous 10 years, a survey of cardiac invasive and surgical procedures in Switzerland was carried out by a standardised questionnaire. At the 25 Swiss centres (10 public non academic, 10 private and 5 academic centres) a total of 11,198 coronary revascularisation procedures were performed, the majority of them (60%) by percutaneous transluminal coronary angioplasty (PTCA). Of all PTCAs, 89% were single vessel interventions. PTCA for ongoing infarction accounted for 6% of all PTCAs. The use of coronary stents has increased to 28% of all angioplasties. Other devices like directional atherectomy and rotablations have lost ground (41 cases). Thirteen interventions with intracoronary laser catheters were recorded. Among the new diagnostic tools, only coronary ultrasound has been used regularly (191 cases). Percutaneous balloon valvuloplasties (64 cases) and catheter closure of congenital shunt defects (32 cases) remained rare interventions. Procedure related mortality for PTCA was 0.7%, infarction occurred in 1.1% and emergency coronary artery bypass grafting (CABG) became necessary in 0.7%. For the first time, the total number of CABGs (4485) decreased. Among the 2077 non-coronary operations, 56% were performed for valve disease and 44% for congenital heart disease. Heart transplantation was performed in 44 patients. The majority of interventional catheter procedures were performed at the 5 university centres whereas the majority of CABGs were carried out at private centres. Four centres performed diagnostic procedures, exclusively. In-house surgical stand-by for PTCA was present in 17 of the 21 interventional centres.