FIRST ANNUAL-REPORT FROM THE REGISTRY OF THE -ANGIOGRAPHY-AND-INTERVENTIONS-IN-PRIVATE-PRACTICE - RESULTS FOR 1996

The German Society for Cardiac Angiography and Interventions in Privat e Practice has started a registry of cardiac procedures since 1996 in order to establish a standard for performance. Although quality manage ment for the cath lab makes sense and is also legally required, there is no generally recommended infrastructure for quality assurance exist ing in Germany at this time. Therefore, the German Society of Cardiolo gists in Private Practice (BNK) initiated a project in 1994 to develop a computer program for paperless documentation of diagnostic cardiac catheterizations and coronary interventions (PTCA) using a minimal dat a set. In 1996, 8 private associated groups participated in this proje ct. The (anonymous) analysis of 10,316 diagnostic cardiac catheterizat ions and 2597 PTCA yielded the followig results: In 95% of the patient s, diagnostic cardiac catheterization was performed using the femoral and in 5% the brachial/radial approach. The mean volume of administere d contrast medium was 164 +/- 138 ml/patient. The mean LV-EF was great er than 50% in 58.4% of the patients and between 30% and 50% in 10.1%. Coronary artery disease was diagnosed in 69.6% of the patients and va lvular/congenital heart disease in 8.5%. In 18.4% of the patients unde rgoing diagnostic cardiac catheterizations no significant heart diseas e was identified. Mortality in the cath lab as well as the rate of cer ebral insults was 0.05%. In 22.9% and 19% of the patients PTCA and car diac surgery respectively was recommended. In patients undergoing PTCA , stable angina was present in 74.4% and unstable angina in 13.1%. Of the total number of PTCA procedures, 5.8% were performed in the settin g of acute myocardial infarction. The PTCA lesion success rate was 96% , the mean diameter stenosis was 81% pre and 6% post-intervention. The mortality rate at 1 month post-PTCA was 0.4%, and myocardial infarcti on 1.0%. An acute occlusion occurred in 1.3% of the PTCA patients; 0.6 % had to be transferred for emergency bypass surgery. None of the cath labs had on-site surgery. In comparison to other registries, our data show some similarities but also some different trends. Thus, our newl y developed software proved to be reliable, fast and easy to use. Part icipating centers receive immediate feedback regarding their posititon within the whole group.