Coronary angiography, angioplasty, heart valve replacement surgeries have returned to pre-Covid levels: after the forced stop imposed by the pandemic and a 2020 in which the number of interventional cardiology procedures decreased by almost 20% on average, today the interventions register a double-digit increase compared to the previous year and the volume of procedures is equal to that of 2019. Photographing the growing trend is the activity register of the 273 Italian laboratories of hemodynamics and interventional cardiology, whose data were discussed by the experts of the Italian Society of Interventional Cardiology (Gise) during the ‘Gise Think Heart’ congress in Naples.
In 2021, for example, 146,529 angioplasties were performed compared to 133,168 registered in 2020, the Tavi were 9,911 against only 7,605 carried out in 2020, while there are 278,312 diagnostic coronary arteries performed throughout the country. The Registry data relating to last year show how, above all thanks to the commitment of health personnel, it has been possible to recover to a large extent the delays due to the pandemic in terms of heart-saving interventions.
However, experts report that “patients today often have a more compromised cardiac picture than in the past and also for this reason it becomes increasingly necessary to make an effort to optimize the organization of the routes between hospital and territory, so as to better manage – they warn – the resources available and guarantee citizens the best results in terms of quality of life after the interventions “.
“In 2021 we can finally say that we have recovered most of the delays in interventional procedures due to the pandemic: the number of coronary angioplasty with stents, for example, has grown by 10% compared to 2020 and that of the Tavi by 30%, interventions for reduce the risk of stroke such as percutaneous occlusion of the left auricle or occlusion of the patent foramen increased by 30-35% – remarked Giovanni Esposito, president of Gise and director of the Uoc of Cardiology, Hemodynamics and UTC of the University Hospital Federico II of Naples – All this has been made possible above all thanks to the commitment and self-denial of the staff, who have not increased but rather decreased “.
However, “some critical issues are not lacking and Italy, especially for the application of new technologies – explains Esposito – is still among the last in Europe: transcatheter repair of the mitral valve, for example, has grown by only 5% and above all not it is still widespread at levels acceptable for the clinical needs of citizens. In addition, about 10,000 Italians have had access to the Tavi and the use of this procedure is growing, but the Tavi data per million inhabitants still show a treatment gap and above all a ‘accentuated regional variability, indicating that still many people who would have indications for therapy, whose audience has also expanded with the most recent scientific guidelines, do not receive it “.
Finally, “even in the case of coronary angioplasty with stents, the data are not all positive, although it can be said that the impact of Covid has been partially recovered in terms of number of services: especially in the first phase of the pandemic, in fact, patients have avoided going to hospital even in the presence of heart attack symptoms, so now the number of more complex and compromised patients is greater, with worse long-term outcomes on overall cardiac function “, comments Esposito asking” an effort to optimize the ‘organization of the routes between the hospital and the local area, so as to better manage the resources available and guarantee citizens the best results in terms of quality of life after the interventions “.
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