Audit of cardiac catheterisation in a district general hospital: implications for training

Objective-To assess complications of diagnostic cardiac catheterisation in a nonsurgical centre by review of the first three years' experience and audit of 2804 diagnostic left heart procedures. Design-Analysis of a prospective database of cardiac catheter procedures. Setting-District general hospital without available on site cardiac surgery. Results-The rate of major complications of cardiac catheterisation was 0.07%. Mortality was 0.07%, and the rate of arterial complications (requiring surgical repair) was 0.24% for brachial arteries and 0.17% for femoral. These results are comparable to those reported from national and international surgical centres. Conclusion-A diagnostic cardiac catheterisation service can be offered in non-surgical hospitals without an increased risk to patients. It highlights the relevance of training in angioplasty and questions the appropriateness of starting preliminary invasive cardiology training of specialist registrars in district general hospitals.