Heart 1997;78:325-326 ( October )
Editorial
Transferring patients for primary infarct angioplasty
| The first 150 words of the full text of this article appear below. |
Although primary angioplasty (PTCA) achieves reperfusion in
acute myocardial infarction (AMI) more readily than thrombolysis without the risk of intracranial haemorrhage, economic and logistic issues limit its applicability.1 Most patients with AMI
present to hospitals without cardiac catheterisation facilities, let
alone PTCA expertise. The safety and feasibility of the emergency
transfer of such patients for primary PTCA have been reported by
Zijlstra et al in Zwolle, a high volume centre in the
Netherlands performing 1600 angioplasties annually.2
During five years there were 520 cases of primary PTCA, 104 of which
were transferred from other hospitals, 91% from within a 50 km
radius. One patient was ventilated before transfer. During transfer,
another was intubated, three patients had ventricular fibrillation or
tachycardia, and one of 10 patients in cardiogenic shock on inotropic
support died. Although the time lost between admission to the local
hospital and arrival at the PTCA laboratory averaged 70 minutes, the
first balloon inflation was
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