Harvard Heart Letter

Heart Beat: Drive-through angioplasty?

Heart Beat

Drive-through angioplasty?

Given what angioplasty involves "" having your heart fixed from the inside out "" it is a remarkably safe procedure. In fact, it is getting so safe that experts are exploring whether everyone who undergoes the procedure needs to spend the night in the hospital.

Several European studies have indicated that staying overnight need not always be standard operating procedure. The latest, a randomized trial from the Netherlands published in the May 1, 2007 Circulation, suggests that about 80% of people who have uncomplicated, nonemergency angioplasty can go home the same day.

Do they want to? That's a big question, writes Dr. Frederic S. Resnic in an editorial that accompanied a report of the trial. Although the Dutch study indicated that patients were more satisfied with going home after a few hours of observation than they were with an overnight stay in the hospital, "I haven't yet found a patient interested in a same-day discharge," says Dr. Resnic, who directs the Cardiac Catheterization Lab at Harvard-affiliated Brigham and Women's Hospital. Most people find it reassuring to spend a night in the hospital after angioplasty, just in case something happens. Hospitals may also balk at same-day discharges, since eliminating the overnight stay could expose them to extra liability in case of complications, and it would mean a loss of revenue.

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