Analysis of the complications of cardiac catheterization over nine years.

The mortality and morbidity associated with cardiac catheterization at the Minneapolis VA Medical Center has been analysed over a period of nine years (1971-1979) in order to identify correctable problem, obtain accurate data for patient information, and allow comparison with other institutions. In common with reports from other catheter laboratories, the mortality has fallen from 0.74% (952 patients) between 1971 and 1975 to 0.24% (819) patients between 1976 and 1979. There has been a similar decline in the combined incidence of myocardial infarction and cerebral embolism from 1.05% to 0.24% over the same period. Our patients with ischemic heart disease included many at high risk of complications in that three vessel disease was present in 53% and the ejection fraction was less than 50% in 24% of cases. In order to ensure that the best standards of cardiac catheterization are maintained, we agree with a recent suggestion that there should be a national surveillance program monitoring fatality and complication rates in all catheterization laboratories.