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Österr.Kardiol.Gesellschaft 1990 Arbeitsgruppe Intervent. Kardiologie Monitor (Auditor) Report: 2007/2008.

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Presentation on theme: "Österr.Kardiol.Gesellschaft 1990 Arbeitsgruppe Intervent. Kardiologie Monitor (Auditor) Report: 2007/2008."— Presentation transcript:

1 Österr.Kardiol.Gesellschaft 1990 Arbeitsgruppe Intervent. Kardiologie Monitor (Auditor) Report: 2007/2008

2 European Society of Cardiology WG 10 – EAPCI (2006) n AUSTRIA 1990 -2008 BERNESC

3 Contact and References: Contact and References: n http://iik.i-med.ac.at (L.Kaltenbach, KP Pfeiffer) n www.kardiologie.insel.ch/2164.html (B Meier - St Cook – MT Maeder) n CARDS; EU Heart J. 2005;26: 308-313 (ESC-WG 10; F.Weidinger) n www.herzbericht.de (E.Bruckenberger)

4 Volker Mühlberger, Quality AUSTRIAN ANGIOGRAPHY +/- PCI- CENTERS 2007 AUSTRIAN ANGIOGRAPHY +/- PCI- CENTERS 2007 n 4 Pediatric n 34 Adult ( 10 in Vienna) n Rooms (n=46) n http://iik.i-med.ac.at http://iik.i-med.ac.at n 2008: Waidhofen,Braunau, SMZ-Süd

5 Volker Mühlberger, Quality 103 parameters were reported by all 31/30/32 cathlabs 2003/2004/2005 0 20 40 60 80 100 120 99,03 96,12 93,2 90,2987,38 84,47 81,55 78,64 75,73 72,82 69,9 66,99 64,08 61,1758,25 55,34 52,4349,51 46,6 43,69 40,78 37,86 34,95 32,04 29,13 26,21 23,3 20,39 17,48 14,5611,65 8,74 5,83 2,91 % ausgefüllte Zeilen % Cathlabs 2003 2004 2005

6 Volker Mühlberger, Quality AUSTRIA 2006/2007 Angiography 50.667 52.260 PTCA=PCI 19.263 19.342 -stent 90% 90% - - DES 69% 64% OP-CAD(Unger) 2.801 3.316 OP-CAD (Bruckenberger) 4.194 OP- valve 2.700 2.691 OP- valve (Bruckenberger) 2.127

7 Volker Mühlberger, Quality Coronary Angiography Frequency per One Million Inhabitants Coronary Angiography Frequency per One Million Inhabitants

8 Volker Mühlberger, Quality PCI Frequency per One Million Inhabitants (AU/CH/D/CZ/NO) PCI Frequency per One Million Inhabitants (AU/CH/D/CZ/NO)

9 Volker Mühlberger, Quality % PCI/ CA 1992-2007 (AU/CH/D)

10 Volker Mühlberger, Quality n= 32 centers - Austria 2005; according to incremental PCI/CA % quota (n=)

11 Volker Mühlberger, Quality n= 32 centers - according to incremental PCI/CA % quota in Austria 2005; (%=)

12 Volker Mühlberger, Quality PCI during Diagnostic Angio (%) in Austria/Switzerland/EU

13 Volker Mühlberger, Quality %-multivessel PCI Austria/EU %-multivessel PCI Austria/EU

14 Volker Mühlberger, Quality Ratio of (CABG-OP+PCI) per Angiography in AU CH D

15 Volker Mühlberger, Quality PCI Hospital-Mortality (%) in Austria, Switzerland,Germany, EU

16 Volker Mühlberger, Quality Elective (non-acute) and Overall – PCI-Hospital-Mortality (%) in Austria

17 Volker Mühlberger, Quality Non-acute and Overall - PCI Hospital-Mortality (%) in Austria

18 Volker Mühlberger, Quality Ratio of STENTING per PCI (%) in AU/CH/D

19 Volker Mühlberger, Quality Ratio of emergency CABG due to PCI (%): Austria/Switzerland,EU

20 Volker Mühlberger, Quality EMERGENCY CABG AFTER PCI (%): MORTALITY in Austria EMERGENCY CABG AFTER PCI (%): MORTALITY in Austria

21 Volker Mühlberger, Quality Infarction as Complication (%) after PCI in Austria, CH, D, EU

22 Volker Mühlberger, Quality STEMI PCI / acute PCI % Austria 2007 - all Centers

23 Volker Mühlberger, Quality acute/nonacute PCI % Austria 2004 - all Centers

24 Volker Mühlberger, Quality Mortality with/without backup Austria 2006

25 Volker Mühlberger, Quality acute PCI (% of total PCI) in Austria, Switzerland, EU

26 Volker Mühlberger, Quality PCI (n) for acute & subacute Myocardial Infarction in Austria PCI (n) for acute & subacute Myocardial Infarction in Austria

27 Volker Mühlberger, Quality MORTALITY (%) after PCI for acute & subacute Myocardial Infarction in Austria MORTALITY (%) after PCI for acute & subacute Myocardial Infarction in Austria

28 Volker Mühlberger, Quality % GP IIb/IIIa for PCI (AU/CH)

29 DRUG ELUTING STENTS (%of stents) (DES) in 34 Austrian Centers 2006/2007

30 Volker Mühlberger, Quality DRUG ELUTING STENTS (DES) in AU,CH,D,EU (% of stents)

31 Volker Mühlberger, Quality DRUG ELUTING STENTS (DES) in Austria (n) DRUG ELUTING STENTS (DES) in Austria (n)

32 Volker Mühlberger, Quality DRUG ELUTING STENTS (DES) versus REDO in Austria (%) DRUG ELUTING STENTS (DES) versus REDO in Austria (%)

33 Volker Mühlberger, Quality Puncture site closing devices (% of PCI in AU/CH)

34 Volker Mühlberger, Quality Brachial and Radial Approach (% of PCI in AU/CH) Brachial and Radial Approach (% of PCI in AU/CH)

35 Volker Mühlberger, Quality OLD and NEW DEVICES, Austria

36 Volker Mühlberger, Quality NEW DEVICES Austria 2002 – 2007 (winner) n Gerinnselentferner 148/173/213/380/580/950 n Stammzelltherapie m.Katheter 21/16/23/12/40 n NOGA Mapping 16/26/26/21/65 n Alkoholablation = PTSMA 4/4/6/15/11/16 n Defektverschlüsse 162/243/269/332/214/202 n Thrombininjektion bei lokaler Gefäßkomplikation -/ 88/143/115/77 n -/-/-/-/ 60 n Optical coherence tomography (OTC)-/-/-/-/ 60

37 Volker Mühlberger, Quality NEW DEVICES Austria 2002 – 2007 (loser) NEW DEVICES Austria 2002 – 2007 (loser) n Brachytherapie 163/101/28/3/0/0 n Ultraschalltherapie 1/0/0/0/0/0 n Transmyokardialer Laser 16/0/13/0/0/0 n Spinal Cord Stimulation 4/0/0/0/0/0 n Herzohrverschluss links 7/4/13/0/0

38 Volker Mühlberger, Quality NEW DEVICES III Austria 2003 - 2007 NEW DEVICES III Austria 2003 - 2007 n PCI wg. instent-Restenose 737/921/905/1359/1003 n - wegen akuter Stentthrombose -/-/-/-/ 85 n - wegen STEMI -/-/-/-/ 3342 n DES 620/2938/6430/11209/12037/ 11217 n stereotaktische Drahtnavigation -/-/-/-/ ? AKH n perkutaner Aortenklappenersatz –/-/-/-/30

39 Volker Mühlberger, Quality Case load per physician PCICA

40 Volker Mühlberger, Quality NUMBER OF CENTERS WITH HIGH OR LOW CASE LOAD FOR CA DURING 2000/06 NUMBER OF CENTERS WITH HIGH OR LOW CASE LOAD FOR CA DURING 2000/06

41 Volker Mühlberger, Quality NUMBER OF CENTERS WITH HIGH OR LOW CASE LOAD FOR PCI DURING 2000/06

42 Volker Mühlberger, Quality CASE LOAD FOR PCI / CA DURING 2007 ACCORDING TO REGIONS OF AUSTRIA

43 Volker Mühlberger, Quality CASE LOAD FOR PCI / CA DURING 2007 ACCORDING TO REGIONS OF AUSTRIA

44 Volker Mühlberger, Quality Diskussion in Linz am 28.11.2008 Diskussion in Linz am 28.11.2008 n warum CA + PCI rückläufig? n warum Unterschiede PCI/CA ? n PCI/CA als Qualitätskriterium? n REDO trotz DES n ANTWORT: kommen wir in AUT nicht an die culprit lesions heran? Patient? Zuweiser? Finanz? Wir?


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