This item was published during the term of a previous administration that ended in April 2007
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Scots benefit from heart treatment advances
09/02/2004
Thousands of Scots are benefiting from new advances in
heart operations and a fall in waiting times.
In its first report published today the Scottish
Coronary Revascularisation Register highlights progress
between 1997 and 2003 during which:
- a total 34,468 patients have been treated
- numbers of patients treated annually have risen
considerably from 4,661 in 1997 to 7,024 last year
- improved outcomes with relatively low mortality
despite increasing numbers of elderly & frail
patients
This has been accompanied by a huge fall in waiting
times for revascularisation. Figures from NHSScotland's
Information and Statistics Division (ISD) confirm a fall of
nearly five months over that period for patients awaiting
bypass surgery.
The Register is the product of collaborative work by
cardiologists and cardiac surgeons in 12 Scottish
hospitals.
Dr Jill Pell, Chair of the Register, said:
"This report is the result of a tremendous amount of
hard work by clinicians across the country.
"We believe the Register to be unique in Europe because
in Scotland we are able to follow-up patients routinely
long-term and show that their outcome many years after
treatment has improved dramatically.
"By working together to produce the Register we have
shared and developed best practice. That has helped improve
the quality of services for patients and also their
long-term prognoses."
Revascularisation can be done by surgery using bypass
grafts (CABG) or, increasingly, by angioplasty through
percutaneous coronary intervention (PCI) using a catheter
to expand the artery with a balloon and then inserting a
stent - expandable metal tubing - to keep the widened
artery open.
Dr Mac Armstrong, Scotland's Chief Medical Officer,
said:
"This is an excellent piece of work. Coronary
revascularisation has been one of the great success stories
of recent years. It is giving new lease of life to
thousands of people by quite literally getting their blood
flowing again.
"Advances in treatments mean that older patients and
those suffering from diabetes, high blood pressure and
other diseases are now able to benefit.
"I commend the efforts of all the clinicians involved
both in delivering these improvements and in producing this
invaluable report. It is a significant and welcome
addition to a series of publications by professional bodies
looking at health service delivery. Using these reports,
we can drive up standards of care and give the public a
much clearer picture of the services which are available
for them."
In the year ending June 1997, the median wait for CABG
was 195 days, according to the ISD. This had fallen to 53
days by June 2003, a reduction of nearly five months.
Angioplasty is increasingly being used at the same time
as the diagnostic test (angiography) rather than putting
the patient on a second waiting list. It is also being used
more commonly in urgent and emergency cases where
revascularisation may not previously have been used.
Mr Alan Faichney, consultant cardiothoracic surgeon at
North Glasgow, said:
"Over the past decade there have been a number of
significant advances in coronary revascularisation
procedures, which have made a big difference to how
patients are treated and how long they have to wait for
treatment.
"Three years ago patients were waiting over a year for
treatment but now the average wait in my unit is less than
18 weeks with many patients undergoing surgery within a few
weeks of referral."
Dr Keith Oldroyd, consultant cardiologist at Glasgow's
Western Infirmary, said:
"There are two developments driving the increasing use
of angioplasty. Firstly, both angioplasty and bypass
surgery can bring major improvements for patients who have
significant angina despite medication. But new guidelines
recommend angioplasty as the preferred first time option as
it is much less invasive and patients recover much more
quickly.
"Secondly, it has become apparent that for some patients
admitted to hospital as an emergency with chest pain, the
best way to treat them is to perform an angiogram as early
as possible and then to insert stents into any severely
narrowed arteries. "Patients can be discharged home earlier
and return to normal activities more quickly than they can
following surgery."
The Scottish Coronary Revascularisation Register was set
up in April 1996. It uses data on diagnosis and
revascularisation from 12 NHS hospitals in Scotland. The
Register also provides information on events after
discharge - even if they occur in the community or in a
different hospital.
The Register is the latest in a series of recent
independent reports - including the Scottish Audit on
Surgical Mortality and outcome indicators from NHS Quality
Improvement Scotland - giving a detailed insight into the
health service.