Purpose: To identify patients suitable for outpatient cardiac catheterization strategy, based on social aspects, risks and complications, for a 24 hour period.
Methods: In a series of 2.126 cases submitted to cardiac catheterization at the Instituto Dante Pazzanese de Cardiologia, between September 1990 and June 1991, were excluded: a) those over 75 years of age; b) the acute ischemic syndromes; c) those in NYHA functional class IV; d) patients who used 7 or 8 French femoral angiographic catheters; e) patients who had undergone general anesthesia, electrophysiological study or endomyocardial biopsy. After the procedure, the patients were observed for a 3 hour period and in the absence of any complication, they were discharged from the hospital, returning the next day for clinical evaluation. If any complication occurred it was registered.
Results: In a cohort of 719 eligible patients, 68% were male, with a mean age of 55.3 years. Sixty one per cent were in NYHA functional class I and most of them (80.8%) were studied by the brachial approach. Eighty-three per cent of the patients were submitted to coronary angiography, with 52% of them having coronary artery disease. Four hundred and fourteen patients were not discharged on the same day: 217 did not have their procedures finish after 6 p.m., 111 for social-economical reasons, 23 because of their physician's refuse, 8 because of left main coronary disease, 55 because of any kind of complication. All the 305 patients who were discharged on the same day, did not have shown any complication in the next day evaluation.
Conclusion: Outpatient cardiac catheterization is a safe technique in selected patients, making possible the accomplishment of a greater number of procedures improving bed utilization and decreasing hospital costs.