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Second Congress of Cardiology and Angiology of Bosnia & Herzegovina

 

FEASIBILITY AND SAFETY OF OUTPATIENT PERCUTANEOUS CORONARY ARTERY INTERVENTION
M. Brzezinski, A. Basti, P-C. Fournet, J. Noble, P. Schopfer, L. Finci and P. Urban.
Hopital de la Tour, Geneve, Switzerland

Elective percutaneous coronary interventions (PCI) are currently associated with success rates >95% and no longer require complex post-intervention monitoring and management. We evaluated the feasibility and safety of outpatient PCI in patients scheduled to remain in our hospital for less than 24 hours. 209 consecutive outpatients underwent PCI between January 1998 and December 2000. in 89% of cases this was done during the same session as diagnostic coronarography ("ad hoc" PCI). the patients (age 64 +/- 20, 23% female) were investigated because of stable angina (68%), unstable 13,4%), silent ischeamia (12%), or post MI (6,6%). 104 patients (50%) had single, 105 (50%) multiple vessel disease and 22 (11%) had prior CABG. The procedure, through a femoral 6F sheath, was successful in 205 patients (98,1%), with 4 failures (1,9%), related to chronic total occlusion. 173 patients (83%) underwent single vessel and 36 (17%) multivessel PCI. 37 (18%) had PTCA only, 115 (55%) had one stent and 57 (27%) had ³ 2 stents implanted. After PCI, all patients were monitored 2 to 6 hours in the ICU before returning to the outpatient ward. During the hospital period, there were no deaths or need for emergent CABG. 1 patient (0,5%) suffered from a Q wave and 3 (1,4%) a non-Q wave myocardial infarction. 3 of these 4 patients (1,4%) remained in hospital for more than 24 hours. One patient (0,5%) was successfully treated as an outpatient for an access site pseudo-aneurysm. 100 of the first 103 patients could be contacted for a routine 30 days follow up. There was no death, further myocardial infarction, need for CABG or hospital readmission. Ambulatory PCI appears feasible and safe, only rarely requires conversion to full hospitalisation and should prove to be a cost-effective approach for myocardial revascularisation.

Drugi kongres kardiologa i angiologa Bosne i Hercegovine
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