Study of emergency disposal model on acute myocardium infarction-inverse transportation between county hospital and regional health center

Objective: To explore the emergency treatment model for interventional treatment of acute myocardium infarction in county hospital, and evaluate the safety, effectiveness and feasibility of emergency percutaneous coronary intervention (PCI). Methods: From September 2002 to September 2008, there were a total of 126 cases of acute myocardial infarction for the local PCI treatment by interventional cardiologist (transport doctor). In these cases, 69 men and 57 women with the mean age of 66.3±3.5 years old (ranging from 28 to 83 years old), meanwhile, 83 cases anterior wall myocardial infarction and 43 cases inferior wall myocardial infarction (15 cases with right ventricular infarction) with onset time of 2-12 h and the mean time of 5.8±1.1 h. Results: There were 126 cases accepted CAG, of which 3 cases triple vessel lesion were suggested for CABG, 1 case extensive anterior wall myocardial infarction with Tako-tsubo ardiomyopathy as final diagnosis, without vascular lesions but cuttlefish ball-like occurred in left ventriculography. 3 cases presented thrombosis autolysis, and another 2 cases of surgical failure. The rest 117 cases were all treated with PCI, and the success rate reached 98.3%. There were 8 cases suffered surgery peri operative period cardiac events, and 4 cases deaths (3.4%) occurred after the procedure. Conclusions: Inverse transportation model is significantly effective to treat acute myocardium infarction, which can provide support for the organization and technology for acute heart interventional treatment during the initial period in county hospital.