Heart interventions in Switzerland 1996

For the year 1996, as for the previous 11 years, a survey of cardiac invasive and surgical procedures in Switzerland was carried out by a standardised questionnaire. At the 25 Swiss centres (10 public non-university, 10 private and 5 university centres) a total of 12,183 coronary revascularisation procedures were performed, 60% by percutaneous transluminal coronary angioplasty (PTCA). Of all PTCAs, 88% were single vessel interventions. PTCA for ongoing infarction accounted for 6% of all PTCAs. The use of coronary stents has increased to 50% of all angioplasties. Other interventions like directional atherectomy and rotablations have lost ground (0.4%, 35 cases). Only 22 interventions (0.2%) with intracoronary laser devices were recorded. Among the new diagnostic tools, only coronary ultrasound (233 cases) and Flowire (147) have been used regularly. Percutaneous balloon valvuloplasties (60 cases) and catheter closure of congenital shunt defects (42 cases) remained rare. Procedure related mortality for PTCA was 0.6%, infarction occurred in 1.0% and emergency coronary artery bypass grafting (CABG) became necessary in 0.4%. The total number of CABGs (4,463) slightly decreased. Among the 2,677 non-coronary operations, 48% were performed for valve disease and 51% for congenital heart disease. Heart transplantation was performed in 41 patients (1%). Half of the interventional catheter procedures were performed at the 5 university centres whereas the majority of CABGs were carried out at private centres. Four centres performed diagnostic procedures, exclusively. In-house surgical stand-by for PTCA was available in 17 of the 21 interventional centres.