Thirty years of standalone percutaneous coronary interventions: A 23,261 case experience from a Canadian tertiary referral centre

William KK Hui, David G O Brien
2015 Current Research Cardiology  
WKK Hui, DG O'Brien, NS Brass, et al. Thirty years of standalone percutaneous coronary interventions: A 23,261 case experience from a Canadian tertiary referral centre. Curr Res Cardiol 2015;2(4):183-187. BACKGROuND: When percutaneous coronary intervention (PCI) was first performed >35 years ago, on-site cardiac surgery backup for PCI failure was deemed essential. As techniques improved and primary PCI became the preferred reperfusion strategy for acute myocardial infarction, many standalone
more » ... many standalone PCI programs originally established to facilitate access to primary PCI started to perform elective PCI, which remains a Class IIb recommendation in American College of Cardiology Foundation/American Heart Association/Society for Cardiac Angiography and Interventions guidelines. Two recent United States studies showed that outcomes of elective PCI in standalone centres were noninferior to those with on-site cardiac surgery. The Royal Alexandra Hospital in Edmonton (Alberta) performed the first standalone PCI in Canada in 1981. OBjeCTiveS: The authors describe their first 30 years' experience with PCI -the largest single-centre standalone experience reported to date. MeTHODS: Patient and procedural data have been collected since the first standalone PCI in 1981, evolving from paper records to a computer database and, in 1995, a provincial database. Quality assurance and peer review in collaboration with the regional cardiac surgery program was established from the outset. ReSulTS: The success, emergency coronary bypass and death rates for 23,261 standalone PCIs performed between 1981 and 2011 were 96.0%, 0.2% and 0.5%, respectively. For 9068 PCIs performed between 2007 and 2011 (a period that most reflects contemporary practice), the rates were 96.5%, 0.04% and 0.6%, respectively. These results compare favourably with PCI results reported in literature, irrespective of the presence or absence of on-site cardiac surgery. CONCluSiONS: With high volumes and an experienced team, standalone PCIs can be performed safely with excellent success and low complication rates.
doi:10.4172/2368-0512.1000048 fatcat:orlniojmuvbdhlkc5rz4rbdaze