Initiation and operation of a primary PTCA program.

Since beginning primary angioplasty in the early eighties we have used angioplasty in or related to acute myocardial infarction in over 2,300 patients. We will review here the use of direct, immediate, rescue and deferred or elective angioplasty in acute myocardial infarction. Organization of the cardiac catheterization laboratory staff, transport programs, and planning for surgical stand-by have all contributed to patient benefit in our program and will be outlined. Our acute MI approach both for angioplasty and for follow-up surgery will be reviewed.