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Article
Elective percutaneous coronary intervention without on-site surgical backup: a community hospital experience
WMJ : official publication of the State Medical Society of Wisconsin
  • Mohamed Djelmami-Hani, Aurora Health Care
  • Mouatou Mouanoutoua
  • Abdelazim Hashim
  • Joaquin Solis, Aurora Health Care
  • Lawrence Bergen
  • Neil Oldridge
  • Leo C Egbujiobi
  • Suhail Allaqaband, Aurora Sinai/Aurora St. Luke's Medical Centers, Aurora Health Care
  • Masood Akhtar, Aurora Sinai/Aurora St. Luke’s Medical Centers, Aurora Health Care
  • Tanvir Bajwa, Aurora Sinai/Aurora St. Luke's Medical Centers, Aurora Health Care
Aurora Affiliations

Aurora Sinai/St. Luke's Medical Centers

Publication Date
12-1-2007
Abstract
CONTEXT: The American College of Cardiology guidelines consider elective percutaneous coronary intervention (PCI) without on-site surgical backup (OSB) a Class-III indication. OBJECTIVE: Our objective was to determine the safety of elective PCI without OSB. DESIGN: The study is a prospective analysis of a cohort of patients who underwent elective PCI without OSB at our institution. All patients were at our community satellite institution in Beloit, Wis. Three hundred twenty-one elective interventions were performed (mean age 64 +/-12, 68% male). The prevalence of diabetes and hypertension was 28% and 82.5% respectively. INTERVENTION: A predefined protocol was designed to transfer patients to a cardiac surgical facility if necessary. An experienced interventional cardiologist reviewed the diagnostic angiograms. Patients with complex lesions were excluded from the study. MAIN OUTCOME MEASURE: Any procedure-related death or emergency coronary artery bypass graft surgery. RESULTS: Three hundred eighty-two vessels were stented. Multi-vessel intervention was performed in 61 patients (19%). Only 5% of lesions were type C. Four hundred thirty-seven stents were deployed. IIb-IIIa inhibitors were used in 77 (24%) cases. Procedural success was 99.7%. There were no deaths, myocardial infarctions nor need for urgent target vessel revascularization at 6 months. CONCLUSION: With careful patient/lesion selection, an experienced interventional cardiologist and a predefined transfer protocol, elective PCI without OSB can be performed safely.
Document Type
Article
PubMed ID
18237072
Citation Information
Djelmami-Hani M, Mouanoutoua M, Hashim A, et al. Elective percutaneous coronary intervention without on-site surgical backup: a community hospital experience. WMJ. 2007 Dec;106(8):481-5.