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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 BERNESC

3 Contact and References: Contact and References: n (L.Kaltenbach, KP Pfeiffer) n (B Meier - St Cook – MT Maeder) n CARDS; EU Heart J. 2005;26: (ESC-WG 10; F.Weidinger) n (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 n 2008: Waidhofen,Braunau, SMZ-Süd

5 Volker Mühlberger, Quality 103 parameters were reported by all 31/30/32 cathlabs 2003/2004/ ,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

6 Volker Mühlberger, Quality AUSTRIA 2006/2007 Angiography PTCA=PCI -stent 90% 90% - - DES 69% 64% OP-CAD(Unger) OP-CAD (Bruckenberger) OP- valve 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 (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 all Centers

23 Volker Mühlberger, Quality acute/nonacute PCI % Austria 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 NEW DEVICES III Austria 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/ 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 Diskussion in Linz am 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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