[Heart surgery complications during diagnostic coronary angiography. The experience of a nondepartmental hemodynamics laboratory].

The records of the Catheter Laboratory at S. Carlo Hospital in Milan (a District General Hospital without Cardiac Surgery Unit) between 1989-1991 were reviewed to determine how often emergency coronary by-pass surgery was performed because of a complication arising during elective coronary arteriography. A total of 1,009 cardiac procedures were performed, 876 (87%) were confined to left ventricular angiography and coronary arteriography in patients with suspected coronary artery disease. Our Catheter Laboratory complications rate was low: death 0.1%, stroke 0, non fatal myocardial infarction 0.8%, arrhythmia 0.5%, femoral haematoma 0.7%, emergency cardiac surgery 0. Case selection, seniority of operators, femoral approach (98% of the cases) with coronary catheters 6 French can explain these good results. In our experience coronary angiography at a District General Hospital is safe, feasible and diagnostic. Besides our main problem is the non emergency access to a Cardiac Surgery Unit after coronary arteriography: our patients have to join a long waiting list at major Regional Centres with an increase in cardiac events.