Navigation Links
Angioplasty Safe at Hospitals Without On-Site Surgery: Review

By Denise Mann
HealthDay Reporter

TUESDAY, Dec. 13 (HealthDay News) -- Despite current guidelines, many people who have angioplasty to open blocked heart arteries can safely undergo these procedures in hospitals that don't have on-site cardiac surgery capabilities, according to a new review of 15 studies.

The review found no heightened risk for death or conversion to emergency bypass surgery in individuals who have angioplasty at centers that don't have teams that are ready to perform emergency coronary artery bypass grafting in a pinch.

The findings are published in the Dec. 14 issue of the Journal of the American Medical Association.

Angioplasty can be done urgently after a heart attack or electively to reduce the risk of a heart attack. The new study included more than 120,000 people who had angioplasty immediately following a heart attack. In this setting, timing is of the essence. The risk of dying was 7.2 percent at hospitals where there was on-site surgery and 4.6 percent at centers that did not have this capability. The risk of needing emergency bypass surgery was low for urgent and elective angioplasty patients at centers with and without on-site surgery capabilities, the study showed.

According to guidelines from the American College of Cardiology and American Heart Association, elective angioplasties should only be performed in centers with on-site surgery capabilities. But "for the most part, elective or non-urgent angioplasty can safely be performed at all centers," said study author Dr. Mandeep Singh, a cardiologist at the Mayo Clinic in Rochester, Minn.

"Patients who need primary, emergency angioplasty should be sent to the hospital nearest to where they live," he said. "For elective angioplasty procedures which can wait, it can be decided on a case-by-case basis."

Dr. Scott Kinlay, who wrote an accompanying journal editorial, agreed. "Patients should know that coronary revascularization by [angioplasty] is relatively safe regardless of whether there is on-site [surgery]," he said. If on-site surgery is not available, "patients should know if there are systems in place to transfer them quickly to a hospital if this is required," said Kinlay, director of the cardiac catheterization laboratory and vascular medicine of the VA Boston Healthcare System.

This discussion is not essential following a heart attack. "However, in the non-heart attack setting, it would be reasonable to ask this question," Kinlay said. "At the time the guidelines were written, there was still some doubt about whether on-site [surgery] is a necessity," he added.

Many of the studies only recruited and included patients who are considered low risk. If ongoing trials "come to the same conclusion as this paper, future guidelines may suggest that patients with high-risk features" should have their angioplasty in a hospital with on-site bypass, whereas "[angioplasty] without on-site [bypass] may be more acceptable for the majority of average and low-risk patients," Kinlay noted.

"We should wait for further confirmation by the randomized trials before giving the absolute green light on this," Kinlay said, particularly as these studies may also help define who should have angioplasty in hospitals with on-site bypass surgery.

More information

Visit the U.S. National Heart, Lung, and Blood Institute to learn more about angioplasty.

SOURCES: Mandeep Singh, M.D., M.P.H., cardiologist, Mayo Clinic, Rochester, Minn.; Scott Kinlay, M.D., MBBS, Ph.D., director, cardiac catheterization laboratory and vascular medicine, VA Boston Healthcare System, West Roxbury, Mass.; Dec. 14, 2011, Journal of the American Medical Association

Copyright©2010 ScoutNews,LLC.
All rights reserved  

Related medicine news :

1. Angioplasty Patients May Be at Risk for Rehospitalization
2. South Asian patients require 3 times as much repeat angioplasty as white Europeans
3. Patients fare just as well if their nonemergency angioplasty is performed at hospitals
4. Women No More Likely to Die After Angioplasty
5. Heart Attack Damage Not Reduced by Adding Balloon Pump to Angioplasty
6. Study shows balloon pump use prior to angioplasty does not reduce heart muscle damage
7. Most Heart Attack Patients Who Need Angioplasty Quickly Get It: Study
8. Adherence to Angioplasty/Stent Guidelines Lacking: Study
9. Angioplasty with stents may be safe in long-term for low-risk heart patients
10. Angioplasty may be feasible for liver transplantation candidates with heart disease
11. Cardiac Rehab Can Boost Survival After Angioplasty, Study Finds
Post Your Comments:
Related Image:
Angioplasty Safe at Hospitals Without On-Site Surgery: Review 
(Date:11/27/2015)... Wilmington, DE (PRWEB) , ... November 27, 2015 ... ... a member of the well-respected Microsoft Dynamics SL User Group (MSDSLUG). Recognized as ... is an independent group of Microsoft Dynamics SL software users, partners, industry experts ...
(Date:11/27/2015)... ... November 27, 2015 , ... CBD College is ... Health Education Programs (CAAHEP) awarded accreditation to its Diagnostic Medical Sonography program. CBD College ... as only one of twelve colleges and universities in the state of California make ...
(Date:11/27/2015)... ... November 27, 2015 , ... ... software Q-Suite, announces the incorporation of Asterisk 11 LTS (Long Term Support) into ... Asterisk 11 LTS brings Q-Suite 5.10 up-to-date with a version of Asterisk that ...
(Date:11/26/2015)... , ... November 26, 2015 , ... ... Express Travel Representative. As a franchise owner, Somu now offers travelers, value and ... destination wedding packages, private cruise sales, as well as, cabin upgrades and special ...
(Date:11/26/2015)... ... November 26, 2015 , ... WorldCare International, Inc., the ... 61st annual Employee Benefits Conference. The Employee Benefits Conference was hosted by the ... Wednesday, November 11th, 2015. The conference was held at the Hawaii Convention Center ...
Breaking Medicine News(10 mins):
(Date:11/26/2015)... 26, 2015 Research and Markets ( ... "2016 Future Horizons and Growth Strategies in ... Shares, Country Segment Forecasts, Competitive Intelligence, Emerging Opportunities" ... --> --> This new ... Japanese therapeutic drug monitoring market, including emerging tests, ...
(Date:11/26/2015)... , Nov. 26, 2015 Research and ... the "Advanced Wound Care Market by Type (Dressings, ... End User (In-Patient Facility, Out-Patient Facility), and Geography - ... --> --> ... description, definition and forecast of the global advanced wound ...
(Date:11/26/2015)... , November 26, 2015 ... of the "Radioimmunoassay Market by Type ... Pharmaceutical Industry, Academics, Clinical Diagnostic Labs), Application ... Forecast to 2020" report to their ... announced the addition of the "Radioimmunoassay ...
Breaking Medicine Technology: