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Österr.Kardiol.Gesellschaft 1990 Arbeitsgruppe Intervent. Kardiologie

Österr.Kardiol.Gesellschaft 1990 Arbeitsgruppe Intervent. Kardiologie. Monitor (Auditor) Report: 2007/2008. European Society of Cardiology WG 10 – EAPCI (2006). AUSTRIA 1990 -2008. BERN ESC. Contact and References:. http://iik.i-med.ac.at (L.Kaltenbach, KP Pfeiffer)

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Österr.Kardiol.Gesellschaft 1990 Arbeitsgruppe Intervent. Kardiologie

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

  2. European Society of CardiologyWG 10 – EAPCI (2006) • AUSTRIA 1990 -2008 BERN ESC

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

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

  5. 120 100 80 % Cathlabs 2003 60 2004 2005 40 20 0 93,2 69,9 46,6 23,3 8,74 5,83 2,91 96,12 78,64 72,82 64,08 37,86 29,13 99,03 75,73 66,99 61,17 58,25 43,69 40,78 34,95 32,04 26,21 90,29 87,38 84,47 81,55 55,34 52,43 49,51 20,39 17,48 14,56 11,65 % ausgefüllte Zeilen 103 parameters were reported by all 31/30/32 cathlabs 2003/2004/2005 Volker Mühlberger, Quality

  6. 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 Volker Mühlberger, Quality

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

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

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

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

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

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

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

  14. Ratio of (CABG-OP+PCI) per Angiography in AUCHD Volker Mühlberger, Quality

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

  35. OLD and NEW DEVICES, Austria Volker Mühlberger, Quality

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

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

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

  39. Case load per physician PCI CA Volker Mühlberger, Quality

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

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

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

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

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

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