
MASSDEVICE ON CALL — A study of cardiac procedures in Michigan reveals a disrepancy between treatments, with areas hosting higher concentrations of catheterization labs performing more – and more expensive – stenting procedures than in areas with fewer labs.
In short, if you build a cath lab, they will come.
The study, by the Center for Healthcare Research & Transformation, examined rates of treatment with drugs and with cardiac interventions like stenting. Although the rate of intervention procedures dropped 19% from 1997 to 2008, in some areas that number rose significantly – including 1 area where the intervention rate rose by 11%, with 55% of those classed as elective.
"What happens is when they’re on the table, people are anesthesized, the doctors come out and say to the spouse ‘there’s an indication of a need and we can do it right now,'” Marianne Udow-Phillips, director of the research center, told NPR. “So in many cases, they’re done right then in the cath lab without the benefit of the patients having the opportunity to reflect on the risks and opportunity.”
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Elderly patients suffering from aortic stenosis who are too sick to undergo open-heart surgery may good candidates for transcatheter aortic valve repacement, according to a New England Journal of Medicine study.
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