Angioplasties less effective at hospitals that do fewer of them, research shows

If you want to avoid heart bypass surgery, you may want to “bypass” a hospital that does low volume work in another heart procedure—coronary angioplasty.

Heart patients often get angioplasty to treat narrowed or blocked arteries, and if that doesn’t work, they go on to a bypass operation. Angioplasty involves inserting a small balloon into the blocked artery and gradually inflating it until the vessel is open. Compared to a bypass, it is less invasive, results in shorter hospital stays and has a faster recovery time.

But if you have angioplasty in a hospital that does less than 200 cases a year, your chances of needing bypass surgery are greater than if you had chosen a high volume hospital, say UW researchers. Medicine Professor James Ritchie and colleagues studied 24,000 records from 110 California hospitals. Patients at hospitals performing fewer than 200 angioplasties per year showed a significant increase in the need for bypass surgery later.

Ritchie says coronary angioplasty is a “complex team effort” that requires “a certain level of activity to keep the team functioning optimally.” Both the American Heart Association and the College of Cardiologists recommend that hospitals perform at least 200 angioplasties per year.