0
We're unable to sign you in at this time. Please try again in a few minutes.
Retry
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
Retry
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Editorial |

Is Onsite Surgery Backup Necessary for Percutaneous Coronary Interventions?

W. Douglas Weaver, MD
JAMA. 2004;292(16):2014-2016. doi:10.1001/jama.292.16.2014.
Text Size: A A A
Published online

Extract

The number of percutaneous coronary intervention (PCI) procedures performed each year has increased substantially, particularly since the introduction of coronary stents. The current increase is being fueled by the shift from thrombolysis to the performance of primary PCI for treatment of acute myocardial infarction (MI). Also, with the availability of drug-eluting stents, patients who previously would not have been eligible for PCI are now candidates for this intervention. The drive to treat patients with acute ST-elevation MI (STEMI) in a timely manner poses the question of whether many more moderate-sized and often suburban hospitals, which in most cases do not have cardiac surgery onsite, should provide primary PCI for patients with STEMI. On the surface, it seems unnecessary to provide surgical backup onsite in such programs because the need for emergency surgery for failed PCI for STEMI is small (1% or less).1,2 It would seem adequate to have an emergency plan for patient transfer to a tertiary cardiac hospital in the unlikely event that surgery was needed. Earlier smaller series of patients treated with primary PCI at centers without cardiac surgical backup have shown that this procedure can be done at such facilities and the outcomes are good and comparable to results in centers with onsite surgery.311

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

First Page Preview

View Large
First page PDF preview

First Page Preview

View Large
First page PDF preview

Figures

Tables

References

CME
Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.

Multimedia

Some tools below are only available to our subscribers or users with an online account.

Web of Science® Times Cited: 7

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

Related Content

Customize your page view by dragging & repositioning the boxes below.

See Also...
Articles Related By Topic
Related Collections
PubMed Articles
Jobs
brightcove.createExperiences();