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Primary Angioplasty (PPCI) in Lancashire & South Cumbria

Primary Angioplasty (PPCI) in Lancashire & South Cumbria. Prof Anoop Chauhan Lancashire Cardiac Centre Blackpool. What is New?. Heart Attack Angioplasty Heart CT TAVI. Angio. First 12 months: Data for June 2011 – May 2012. Total of 677 patients (76%) underwent PPCI

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Primary Angioplasty (PPCI) in Lancashire & South Cumbria

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  1. Primary Angioplasty (PPCI) in Lancashire & South Cumbria Prof Anoop Chauhan Lancashire Cardiac Centre Blackpool

  2. What is New? Heart Attack Angioplasty Heart CT TAVI

  3. Angio

  4. First 12 months: Data for June 2011 – May 2012 • Total of 677 patients (76%) underwent PPCI • 889 “potential PPCI cases” seen • 21% had angiography only • 2% false positive • 2% thrombolysis

  5. PPCI numbers by PCT

  6. PPCI Patient Age Distribution

  7. Admission Source • 999 call • LCC (NWAS) • DGH (NWAS) • Self referrals to DGH • Inpatient STEMIs

  8. Procedural outcomes • PPCI success rate (patient alive and TIMI 3 flow at end of procedure) • 94% • Comparable with other centres

  9. Procedural outcomes • 30 day mortality rate • 4.4% • (BCIS 2010 reported national rate 5.7%)* * 7.5% **6.3%

  10. Overall Call To Reperfusion Times: • CTR time is the time from patient call for help to reestablishment of flow in the coronary artery • Target set is CTR of < 150 mins • Achieved in 82.4% of cases • BCIS 2010 average ( 77%)

  11. Overall CTR Target Times Achieved by PCT

  12. “Historical” comparator: Thrombolysis: Achievement of CTT times < 60 mins

  13. Procedural Outcomes: Length Of Stay • Mean LOS for PPCI patients: • 5.4 days • Median LOS for PPCI patients; • 3 days

  14. Summary • A regional PPCI service has been successfully implemented from June 2011 • data is comparable to other units BUT • There is scope for further improvements • Need to increase direct admissions to LCC • Reduce delay in getting an ambulance for Transfer patients • Look at ways to further reduce travel times/reduce delays to effective treatment for South Cumbria patients • Improve further on Door To Reperfusion times

  15. Day case, preadmission, sometimes overnight admission Can not Drive for 2 days 1 in 1000 risk of Death, Stroke, heart attack, need for urgent Bypass surgery Bleeding complications

  16. New Kid on the Block

  17. TAVI

  18. TAVI

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