Cardiac catheterisation without on-site surgical backup

Cardiac catheterization is the preferred method of treatment for most of the heart diseases. Previously it was thought that on-site surgical back up is mandatory for all cardiac catheterization procedures. The superior outcomes of primary PCI are adversely affected by time delays that may be encountered before the patient arrives in the cardiac cath-laboratory. To avoid the inherent delays and to extend this therapy to a larger number of patients, some centers began to perform primary PCI in the absence of on-site cardiac surgery and become routine nowadays. The author worked for ten years in Shahid Gangalal National Heart Center, Kathmandu, Nepal, the only center in Nepal where cardiac surgery was developed first and followed by cardiac catheterisation. More than 1300 procedures were performed here, including primary and elective PCIs, balloon mitral valvotomy, balloon pulmonary valvotomy other diagnostic and therapeutic procedures with internationally accepted complication rate. The data presented in this book reflect author's personal experience and related literature issues.