Chapter 35 - Cardiac Interventions in the Office Interventional Suite

Abstract

Same-day cardiac interventional procedures have evolved due to advances in cardiac care. Performing percutaneous coronary intervention (PCI) on properly selected patients in facilities without on-site surgical backup has been shown to be safe and is supported by evidence and consensus guidelines. Cardiac interventions with PCI and cardiac rhythm management device implants have been safely performed in the office interventional suites (OISs) and ambulatory surgery centers (ASCs) for many years. Properly selecting patients with appropriate comorbidities and lesion characteristics, while making available products and expertise to ensure safe and effective outcomes, is imperative to consider when performing cardiac interventions in the OIS and ASC. Moving more cardiac interventions from an inpatient status to same-day discharge (SDD) will also likely save significant costs. Although significant progress has been made, work needs to be done to modernize coverage policies for certain states and with Centers for Medicare and Medicaid Services (CMS). Future advances in cardiac intervention will likely allow new and more complex interventions to be done safely with a SDD in office or ambulatory surgery care facilities.