Herzeingriffe in der Schweiz 2000

Summary Cardiac interventions in Switzerland 2000 An annual survey of interventional cardiological and surgical procedures in Switzerland has been carried out since 1987 using a standardized questionnaire. Starting with the year 2000 the Swiss Society of Cardiothoracic Surgery will report surgical procedures separately. Data on percutaneous interventions are presented for each center, as well as for the private, public non-university and university sector. A total of 30 404 diagnostic coronary angiographies (+ 9% compared with 1999) and 11080 coronary angioplasties (PTCAs; + 14%) were performed in 2000 at the 28 cardiac centers (5 university hospitals, 10 public non-university hospitals, 11 private hospitals). Coronary angiography prompted a percutaneous revascularization in 36% of cases (35%). After a year of stagnation (1999), the number of cardiac angiographies and percutaneous interventions increased again. An average of 82% (83%) of PTCAs were performed during diagnostic coronary angiography (ad hoc), 85% (87%) were single-vessel interventions, and 11% (10%) were performed during an acute myocardial infarction. Compared with 1999, stent implantation increased from 73% to 78%, the peri-interventional administration of glycoprotein IIb/IIIa receptor antagonists from 17% to 19%, and the use of puncture closing devices from 23% to 39%. Other techniques were rare: 4 directional atherectomies, 32 rotablations, 2 laser angioplasties, 64 brachytherapies, and 12 percutaneous transmyocardial laser revascularizations. Distal protection devices were employed in 365 cases (105 in 1999). There were 215 intracoronary ultrasound studies, 100 intracoronary Doppler, and 225 pressure measurements. The average caseload for the 163 operators performing diagnostic coronary angiographies was 187 cases per year. The 112 PTCA operators performed on average 99 (94) PTCAs. At the 5 university hospitals 39% (44%) of all PTCAs were performed. The reported hospital mortality after PTCA was 0.6% (0.9%), the procedure related rate of myocardial infarction was 1.2% (1.5%), and the need for emergency bypass surgery 0.2% (0.3%). The following non-coronary percutaneous interventions were reported: 88 (68) balloon valvuloplasties, 221 (107) percutaneous shunt closures, and 11 (14) septal reductions for hypertrophic obstructive cardiomyopathy (TASH).