Low-risk percutaneous coronary interventions without on-site cardiac surgery: two years' observational experience and follow-up.

Background: We studied the safety and efficacy of performing low-risk elective and acute infarct percutaneous coronary interventions at a community hospital without cardiac surgical capability.

Methods: Immanuel St Joseph's Hospital is located 85 miles from St Mary's Hospital, which is the nearest center with on-site cardiac surgery. All components of the Mayo Clinic percutaneous coronary intervention program were replicated at Immanuel St Joseph's Hospital, including a telemedicine system to enable real-time consultation with interventional and cardiac surgical colleagues during procedures.

Immediate ambulation following diagnostic coronary angiography procedures utilizing a vascular closure device (The Closer).

Objective: We investigated the safety and efficacy of The Closer, a suture-mediated vascular closure device, to facilitate immediate ambulation after diagnostic coronary angiography.

Methods And Results: We identified 487 non-consecutive patients who were eligible for an immediate ambulation protocol following vascular closure after diagnostic coronary angiography. A total of 434 patients (89%) were allowed immediate ambulation (mean time, 6.