Cardiac catheterization in a freestanding setting.

Cardiac catheterization, originally performed only in hospital settings, is currently undertaken in hospital ambulatory and freestanding settings. Although use of the hospital ambulatory setting is accepted, questions have been raised about the safety and effectiveness of cardiac catheterization when performed in a freestanding setting. Critics have claimed that use of freestanding centers subjects patients to additional risk of complications without affording significant benefits. Proponents maintain that selected cardiac catheterization procedures can be performed in freestanding settings without exposing patients to increased risk. Available data on complication rates indicate that freestanding centers perform catheterizations with morbidity and mortality rates substantially lower than those reported in the literature for inpatient procedures. Although questions have been raised about the validity of these data, they suggest that cardiac catheterization can be performed in a freestanding setting with acceptable safety and effectiveness.