OBJECTIVE To determine whether percutaneous transluminal coronary angioplasty may be safely performed in cardiology centres in the United Kingdom without immediate on site cardiac surgical cover for complications arising at angioplasty. DESIGN Retrospective review of coronary angioplasties and complications in a hospital without on site cardiac surgical cover. SETTING All angioplasties were...

Cardiovascular surgery had great advancement in the twentieth century. In 1929, Werner Forssman performed the first human cardiac catheterization on himself. Then cardiac catheterization gradually became a gold standard in the diagnosis of congenital heart diseases as well as valvular heart diseases. In 1953, Gibbon set a milestone for cardiac surgery by invention of cardiopulmonary bypass. Mas...

The era of percutaneous coronary intervention (PCI) has led to substantial changes in the management of patients with acute coronary syndromes and stable coronary heart disease, with an associated range of impacts on the course and outcomes of subsets of patients with these conditions. Interventional cardiology has moved from percutaneous transluminal coronary angioplasty (PTCA), with or withou...

A 48-year-old woman with Wolff-Parkinson-White syndrome underwent surgical division of the accessory pathway in the left lateral wall. At 6 months after the procedure, she developed dyspnea and chest oppression. Coronary angiography revealed total occlusion in the left circumflex coronary artery (segment 13) at the exact site where cryoablation had been performed. The coronary occlusion was tre...

Rotablation (rotational atherectomy) is an acknowledged method of percutaneous treatment of highly calcified coronary artery lesions that cannot be treated with traditional angioplasty. The complexity of the technique and usage of very specific equipment can contribute to the development of uncommon complications. We present a case of percutaneous retrieval of a damaged rotational atherectomy b...

A puzzling feature of many medical innovations is that they simultaneously appear to reduce unit costs and increase total costs. We consider this phenomenon by examining the diffusion of percutaneous transluminal coronary angioplasty (PTCA)--a treatment for coronary artery disease--over the past two decades. We find that growth in the use of PTCA led to higher total costs despite its lower unit...

Dextrocardia is a rare congenital anomaly of development characterized by a mirrorimage position of the heart. Unlike dextrocardia with situs solitus or ambiguus, the coincidence of congenital heart disease is relatively low among dextrocardic patients with situs inversus. However, patients with dextrocardia may suffer from coronary heart disease as do people with normally positioned hearts. Fe...

W hen Odysseus attempted to sail unharmed between Scylla and Charybdis, he could not have dreamt to ever be quoted in relation to restenosis after percutaneous transluminal coronary angioplasty (PTCA). To be truly successful, balloon dilatation should change the preexistent stenotic lesion to the extent that sufficient luminal widening is achieved and restenosis does not occur. Nevertheless, ap...

ercutaneous transluminal coronary angioplasty (PTCA) was introduced into clinical practice more than 20 years ago. 1 The breathtaking growth of percutaneous coronary interventions (PCI) during the 1990s in Europe (fig 1) reflects their widespread acceptance for coronary revascularisation, challenging coronary artery bypass grafting (CABG). This review provides an overview of current coronary in...