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Primary Angioplasty (PPCI) in Lancashire & South Cumbria. Prof Anoop Chauhan Lancashire Cardiac Centre Blackpool. What is New?. Heart Attack Angioplasty Heart CT TAVI. Angio. First 12 months: Data for June 2011 – May 2012. Total of 677 patients (76%) underwent PPCI
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Primary Angioplasty (PPCI) in Lancashire & South Cumbria Prof Anoop Chauhan Lancashire Cardiac Centre Blackpool
What is New? Heart Attack Angioplasty Heart CT TAVI
First 12 months: Data for June 2011 – May 2012 • Total of 677 patients (76%) underwent PPCI • 889 “potential PPCI cases” seen • 21% had angiography only • 2% false positive • 2% thrombolysis
Admission Source • 999 call • LCC (NWAS) • DGH (NWAS) • Self referrals to DGH • Inpatient STEMIs
Procedural outcomes • PPCI success rate (patient alive and TIMI 3 flow at end of procedure) • 94% • Comparable with other centres
Procedural outcomes • 30 day mortality rate • 4.4% • (BCIS 2010 reported national rate 5.7%)* * 7.5% **6.3%
Overall Call To Reperfusion Times: • CTR time is the time from patient call for help to reestablishment of flow in the coronary artery • Target set is CTR of < 150 mins • Achieved in 82.4% of cases • BCIS 2010 average ( 77%)
“Historical” comparator: Thrombolysis: Achievement of CTT times < 60 mins
Procedural Outcomes: Length Of Stay • Mean LOS for PPCI patients: • 5.4 days • Median LOS for PPCI patients; • 3 days
Summary • A regional PPCI service has been successfully implemented from June 2011 • data is comparable to other units BUT • There is scope for further improvements • Need to increase direct admissions to LCC • Reduce delay in getting an ambulance for Transfer patients • Look at ways to further reduce travel times/reduce delays to effective treatment for South Cumbria patients • Improve further on Door To Reperfusion times
Day case, preadmission, sometimes overnight admission Can not Drive for 2 days 1 in 1000 risk of Death, Stroke, heart attack, need for urgent Bypass surgery Bleeding complications