Herzeingriffe in der Schweiz 1998

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Abstract
Cardiac interventions in Switzerland 1998. For the past 12 years, an annual survey of cardiac invasive and surgical procedures in Switzerland has been carried out using a standardised questionnaire. At the 25 Swiss centres (10 public non-university, 10 private, and 5 university centres) a total of 13 611 coronary revascularisation procedures were performed in 1998, 9651 (70%) by percutaneous transluminal coronary angioplasty (PTCA). The total number of PTCA increased 1998 by 10%. Of all PTCA, 84% were single vessel interventions and 8% interventions for ongoing infarction. The use of coronary stents amounted to 67% of all angioplasties. The periinterventional administration of glycoprotein IIb/IIIa platelet receptor antagonists doubled compared with the previous year to 14% of all PTCA procedures. Other devices like directional atherectomy, rotablation, or intracoronary laser have lost ground and are performed in less than 1% of all procedures. Among the new diagnostic tools, only coronary ultrasound (131 cases) and Doppler flow measurements (103) have been used regularly, mostly for research purposes. Percutaneous balloon valvuloplasties (53 cases) and catheter closure of congenital shunt defects (69 cases) remained rare. The total number of coronary artery bypass grafting procedures (CABG) performed 1998 decreased by 9% (4050). Among the 2428 non-coronary operations, 53% were performed for valve disease and 46% for congenital heart disease. Heart transplantation was performed in 45 patients. Almost half of interventional catheter interventions and CABG were performed at the 5 university centres. Two centres performed diagnostic procedures, exclusively. In-house surgical stand-by for PTCA was present in 17 of the 23 interventional centres. The average PTCA case load was 111 (5–368) per operator and 416 (14–1162) per centre. Procedure related mortality for PTCA was 0.6%, infarction occurred in 1.2% and emergency CABG became necessary in 0.2%.

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