Heart Surgeon Not Required for Elective Angioplasty

Angioplasty and stent placement doesnt require a heart specialist

(RxWiki News) As long as patients seek elective angioplasty and stent placement to open clogged arteries at an experienced hospital, it may not matter whether the medical facility maintains onsite heart surgeons.

Patients who sought the non-emergency procedures at a hospital without dedicated heart surgery capabilities fared as well as those who received angioplasty and stent placement at a hospital with heart specialists.

"Research your options before scheduling elective angioplasty."

Dr. Thomas Aversano, the study’s lead researcher and associate professor of medicine at Johns Hopkins Medical Institutions, said that he does not support the spread of angioplasty to every U.S. hospital, but also noted that it can be expensive and burdensome for medical centers to maintain heart surgery capabilities, and that it doesn't make sense to add more surgical programs just to support additional angioplasty procedures.

During the study researchers randomly assigned 13,995 patients to have the procedures done at a hospital with cardiac surgery capabilities and 4,523 at hospitals without heart surgeon teams. After six weeks, the  death rates were the same for both groups at 1 percent. Neither group was found more likely to later need heart bypass surgery.

Patients were transferred if they needed emergency angioplasty and they were at a hospital without surgical capability. During the study 20 patients from the group at medical centers with on-site surgery and 10 from the other group required emergency surgery.

Previously the American College of Cardiology Foundation and the American Heart Association have recommended that elective angioplasty and stent implantation be performed at hospitals with heart surgery facilities in case emergency surgery was needed. In recent years the need for emergency surgery for those procedures has significantly declined and it has become uncommon, noted Dr. Aversano.

The study only shows short-term results, and in the coming months researchers will know how patients fared after nine months, which will assist in comparing overall patient outcome.

The research was recently presented at the American Heart Association's annual meeting in Orlando, Fla.

Review Date: 
November 15, 2011