Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions
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Catheter Cardiovasc Interv · Apr 2005
Comparative StudyEffect of continuous quality improvement analysis on the delivery of primary percutaneous revascularization for acute myocardial infarction: a community hospital experience.
As time to reperfusion correlates with outcomes, a door-to-balloon time of 90 +/- 30 min for primary percutaneous coronary revascularization (PCI) for the treatment of acute myocardial infarction has been recently established as a guideline by the ACC/AHA. The purpose of this study is to assess the effects of a continuous quality assurance program designed to expedite primary angioplasty at a community hospital. A database of all primary PCI procedures was created in 1998. ⋯ Significant decreases in the time intervals from emergency room registration to initial electrocardiogram (8.4 +/- 8.2 vs. 3.7 +/- 19.5 min; P < 0.001), presentation to the catheterization laboratory to arterial access (13.5 +/- 12.9 vs. 11.6 +/- 5.8 min; P < 0.001), and emergency room registration to initial angioplasty balloon inflation (132.0 +/- 69.2 vs. 112 +/- 72.0 min; P < 0.001) were achieved. For the subgroup of patients presenting with diagnostic ST elevation myocardial infarction, a large decrease in the door-to-balloon time interval between group 1 and group 2 was demonstrated (114.15 +/- 9.67 vs. 87.92 +/- 10.93 min; P = NS), resulting in compliance with ACC/AHA guidelines. Continuous quality improvement analysis can expedite care for patients treated by primary PCI in the community hospital setting.
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Catheter Cardiovasc Interv · Apr 2005
Case ReportsPericardiocentesis ending in the superior vena cava.
Pericardiocentesis is associated with a wide range of complications. We describe a pericardiocentesis attempt ending in the superior vena cava through the route of liver parenchyma, hepatic vein, inferior vena cava, and right atrium.