News | December 14, 2011

Survey of Cardiologists Advocates Rule Change on Angioplasty Without Surgical Backup

December 14, 2011 — A new survey reveals many cardiologists believe angioplasty for hospital heart patients should be allowed even if no heart surgeon is present to perform emergency surgery if needed. The survey, conducted by U.S. News & World Report and theheart.org showed two-thirds of respondents agreed with this change to the current rules.

At present, almost half of U.S. states forbid angioplasty at hospitals without so-called "surgical backup."

The survey is the result of a first-ever reporting collaboration between U.S. News and theheart.org, an online source of cardiology news. The news site surveyed cardiologists who subscribe to its news service; U.S. News invited input from about 600 cardiologists recognized as Top Doctors by itself and by Castle Connolly Medical Ltd.

"Nearly 70 percent of doctors responding to our survey felt the time has come to allow hospitals that lack surgical backup to perform angioplasty, provided they meet certain important criteria," said Steve Sternberg, U.S. News deputy health rankings editor, who wrote the report on the survey results. "At the same time, the overwhelming majority of the doctors felt that hospitals' angioplasty performance should be tracked and publicly reported, and that hospitals with poor results should be required to improve or face loss of the privilege to perform angioplasty."

"The performance of elective angioplasty at hospitals with no cardiac surgery backup on site has long been a hot-button topic among physicians who specialize in the treatment of coronary disease. These survey results suggest that while cardiologists are warming up to the idea of expanding the number of these kinds of facilities, many of them admit that they themselves would opt to be treated somewhere with a surgeon on standby," said Shelley Wood, managing editor of theheart.org.

Other key findings include:

  • In contrast to the majority of survey respondents, one-third of the doctors responded that they do not believe that angioplasty can be performed safely in hospitals without on-site surgical backup. Of these, 66 percent say they're worried about patients' wellbeing; 59 percent say they're concerned that doctors will refer patients for inappropriate procedures in order to sustain the hospital's volume of cases.
  • Nearly 96 percent of respondents endorsed monitoring and public reporting of outcomes for all hospitals that perform angioplasty.
  • More than 95 percent of respondents said hospitals with consistently bad results should be barred from performing angioplasty.

For more information: www.usnews.com, www.theheart.org

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