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[Heart interventions in Switzerland 1996]
1Arbeitsgruppe PTCA und Fibrinolyse, Schweizerischen Gesellschaft für Kardiologie.
Insights
In 1996, Swiss cardiac centers performed 12,183 coronary revascularizations, primarily via percutaneous transluminal coronary angioplasty (PTCA). Coronary stent use reached 50%, while other interventions declined, with low mortality rates for PTCA.
Area of Science:
- Cardiovascular Medicine
- Interventional Cardiology
- Cardiac Surgery
Background:
- Cardiac invasive and surgical procedures in Switzerland are monitored annually.
- In 1996, 25 centers reported on 12,183 coronary revascularization procedures.
Purpose of the Study:
- To provide an annual overview of cardiac procedures in Switzerland for 1996.
- To track trends in interventional cardiology and cardiac surgery.
Main Methods:
- Standardized questionnaire survey of 25 Swiss cardiac centers.
- Data collection on coronary revascularization, angioplasty, bypass grafting, and other cardiac operations.
Main Results:
- 12,183 coronary revascularizations performed, 60% by percutaneous transluminal coronary angioplasty (PTCA); 88% of PTCAs were single vessel interventions.
- Coronary stent use increased to 50% of angioplasties; directional atherectomy and rotablation use decreased significantly.
- Procedure-related mortality for PTCA was 0.6%; emergency coronary artery bypass grafting (CABG) was needed in 0.4% of cases. Total CABGs slightly decreased.
Conclusions:
- Percutaneous transluminal coronary angioplasty (PTCA) dominated coronary revascularization, with increasing stent utilization.
- Less invasive techniques like atherectomy and rotablation saw reduced use.
- Cardiac surgery, including valve disease and congenital heart disease operations, remained significant, with university centers leading in interventional procedures and private centers in CABGs.
Abstract:
For the year 1996, as for the previous 11 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-university, 10 private and 5 university centres) a total of 12,183 coronary revascularisation procedures were performed, 60% by percutaneous transluminal coronary angioplasty (PTCA). Of all PTCAs, 88% were single vessel interventions. PTCA for ongoing infarction accounted for 6% of all PTCAs. The use of coronary stents has increased to 50% of all angioplasties. Other interventions like directional atherectomy and rotablations have lost ground (0.4%, 35 cases). Only 22 interventions (0.2%) with intracoronary laser devices were recorded. Among the new diagnostic tools, only coronary ultrasound (233 cases) and Flowire (147) have been used regularly. Percutaneous balloon valvuloplasties (60 cases) and catheter closure of congenital shunt defects (42 cases) remained rare. Procedure related mortality for PTCA was 0.6%, infarction occurred in 1.0% and emergency coronary artery bypass grafting (CABG) became necessary in 0.4%. The total number of CABGs (4,463) slightly decreased. Among the 2,677 non-coronary operations, 48% were performed for valve disease and 51% for congenital heart disease. Heart transplantation was performed in 41 patients (1%). Half of the 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 available in 17 of the 21 interventional centres.