Ee. Oliveras et al., Requirements to perform coronary interventions at hospitals without coronary surgery. Guidelines of the Spanish Society of Cardiology, REV ESP CAR, 52(1), 1999, pp. 5-12
During the early years of coronary interventions a rigorous on-site surgica
l stand-by was mandatory. The increased experience in coronary angioplasty
both on total number of procedures and the experience gained by each operat
or, together with the technical improvements, namely since the introduction
of stents has induced an evolution in the stand-by strategy, with new conc
epts such as "next available operating room" or coronary interventions "wit
hout on site" surgical facilities, are gaining widespread acceptance.
With the aim of defining the requirements to perform coronary interventions
at hospitals without coronary surgery, the following aspects are reviewed:
a) complications following coronary angioplasty that require coronary surg
ery; b) the current status of coronary angioplasty without surgical stand-b
y in different countries. All this information allows us to advance some re
commendations concerning the performance of coronary interventions at hospi
tals without onsite cardiac surgery. Different issues including hospital ch
aracteristics, operator and cardiac catheterization laboratory requirements
, as well as lesion characteristics and the type of informed consent, shoul
d be taken into acccount.