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The Workload of the Interventional Cardiology Centers from Romania: a 2021 Overview and 2014–2021 Trends


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This article provides data of the workload of the interventional cardiology centers from Romania during 2021, highlighting the trends in coronary and peripheral interventions between 2014 and 20211,2,3,4,5,6,7. Members from all interventional cardiology centers from Romania were requested to fill a standardized form about the total number of various procedures performed during 2021. Data was collected at the initiative of the Interventional Cardiology Working Group of Romanian Society of Cardiology.

Table 1 summarizes the data from 2021 provided by 40 public and private interventional cardiology centers from Romania. Currently, there are 40 interventional cardiology centers in Romania, of which 15 are private centers and 25 are public. In 2021, in Romania were 44 interventional cardiologists in training, 133 full interventional cardiologists and 55 functional angiografs. The exact number of full interventional cardiologist is difficult to know because of some interventional cardiologists are working in public and private hospitals, also.

Reported data from all Interventional Cardiology Centers from Romania in 2021

CITY Hospital Bucharest Cluj Napoca Iasi Târgu Mureș Timișoara Brașov Oradea Suceava Baia Mare Sibiu Constanta Ploiesti Pitesti Pitesti Craiova Tulcea Buzau
CC Iliescu SUUB Floreasca Agrippa Ionescu Militar Bagdasar Elias Sf Ioan Sanador Ares - Monza Colentina Medlife Institutul Inimii Cluj SCJU Cluj Monza - Ares Cluj Sp. Recuperare Cluj IBCV Iași Arcadia Iasi Sp. Sf. Spiridon IBCV Tg Mureș CardioMed Tg. Mures SCJU Tg Mureș Topmed IBCV Timișoara Clinicco Brasov Sp. Jud. Brasov Sp. Sf. Constantin Sp. Jud. Oradea Sp. Jud. Suceava Sp. Jud. Baia Mare Polisano Sibiu Sp. Jud. Sibiu Monza - Ares Constanta Sp. Jud. Ploiesti Sp. Jud. Pitesti Sp. Muntenia Sp. Jud. Craiova Monza - Ares Tulcea Sp. Jud. Buzau
Nr. of Cathlabs 3 2 1 1 3 1 1 1 1 3 1 1 2 1 1 2 3 1 1 2 1 2 1 2 1 2 1 2 UR 3 1 1 1 1 1 1 1 1 1
Nr. of independent operators 7 5 4 2 5 4 6 2 3 2 1 7 10 6 UR 2 6 3 UR 6 6 6 4 7 2 4 3 4 UR 3 1 1 1 2 3 2 1 1 1
Nr. of in-training operators 6 8 0 0 1 1 5 0 0 0 1 0 0 5 UR 0 6 0 UR 3 0 2 0 2 0 0 0 2 UR 0 0 0 1 0 0 0 0 0 1
Coronary Interventions
Coronarographies 2371 1640 1450 612 2512 568 1135 56 1071 1070 175 663 2638 1091 366 335 2667 1208 575 1306 577 892 1206 2653 880 2337 1042 1120 UR 295 800 486 814 560 625 18 1392 25 212
Total nr. of PCI 1070 909 920 117 986 176 636 32 159 493 58 141 2336 620 246 156 1674 150 598 831 236 777 192 1453 391 775 197 557 UR 483 328 163 516 346 387 4 658 17 74
PCI without stents 50 40 UR 14 12 12 41 2 0 1 0 4 64 26 2 20 96 2 54 76 14 16 4 49 7 5 1 29 UR 44 6 5 2 6 33 1 18 1 6
PCI with stents 1020 869 UR 103 974 164 595 30 159 492 58 77 2272 594 244 136 1494 148 544 755 222 761 188 804 384 770 196 526 UR 439 322 158 514 340 354 3 640 16 68
STEMI with primary PCI 485 574 660 6 375 46 450 0 18 0 1 2 618 184 0 0 655 41 150 327 0 385 0 683 2 374 3 242 UR 177 0 19 210 135 195 0 274 0 10
PCI left main 114 52 UR 1 45 14 58 0 10 0 UR 7 68 41 0 15 UR 12 39 56 7 31 16 UR 36 20 6 29 UR 8 12 5 0 10 31 0 18 0 6
CTO UR 20 25 11 63 18 42 0 UR 17 UR 27 20 10 7 8 UR UR 29 UR 8 23 13 UR UR 30 0 53 UR 10 30 18 0 5 23 0 4 0 5
Stents per patient2 1.42 1.39 UR 1.57 2.1 1.58 1.3 1.5 1.42 1.55 1.39 1.64 2.1 2.24 1.4 1.7 1.44 1.5 1.6 1.5 1.32 1.16 1.11 1.93 1.48 1.4 1 1.9 UR 1.2 1.5 1.43 1.16 1.48 1.3 1.2 1.83 1.5 1.54
Total nr. of stents 1458 1264 UR 184 2045 266 831 44 UR 763 81 232 2632 1312 344 260 2408 208 877 1238 293 878 215 2814 579 1282 233 1003 UR 580 484 234 600 505 454 5 1171 26 105
Nr. of DES 1458 1264 UR 184 2033 266 831 44 UR 763 81 232 2632 1312 344 250 2405 208 868 1234 293 878 215 2774 579 1282 233 1003 UR 577 484 234 600 505 454 5 1171 26 105
DES/stents ratio (%) 100% 100% UR 100 99% 100% 100% 100% UR 100% 100% 100% 100% 100% 96% 99% 100% 98% 99,7% 100% 100% 100% 99% 100% 100% 100% 100% UR 99% 100% 100% 100% 100% 100% 100% 100% 0 100%
Cutting, Scoring 15 5 UR 1 22 0 0 0 0 5 0 3 16 1 2 0 0 0 1 UR 0 4 12 0 0 20 3 8 UR 11 0 3 0 5 14 0 16 0 0
Rotablation 8 0 10 1 12 0 0 0 0 7 0 0 6 6 2 0 0 0 1 6 0 5 7 0 0 0 8 19 UR 0 10 0 0 0 5 0 0 0 0
Shockwave 0 0 4 0 0 0 0 0 0 19 0 2 5 1 0 0 0 0 0 0 0 0 2 0 21 0 7 2 UR 0 3 0 0 0 4 0 0 0 0
FFR/IFR 15 9 49 10 2 0 0 0 0 0 0 0 90 0 13 0 0 0 7 29 9 20 0 6 0 50 0 19 UR 13 0 0 0 0 10 0 2 0 0
IVUS 17 0 16 3 0 0 0 0 0 3 0 0 30 0 0 0 0 0 6 0 11 15 0 0 0 0 0 9 UR 0 0 0 0 0 17 0 0 0 0
OCT 5 10 29 1 0 0 0 0 0 0 0 0 22 8 0 0 0 0 14 21 43 0 2 0 15 0 0 UR 2 0 0 0 0 0 0 0 0 0
Peripheral interventions
Peripheral PTA 3 198 0 UR 4 230 0 24 2 73 55 6 22 120 184 59 87 46 42 7 66 86 38 20 39 15 UR 66 16 UR 23 15 49 2 7 69 3 21 0 1
Renal PTA 18 0 UR 0 12 1 0 0 1 2 0 1 8 7 2 5 12 0 5 1 0 1 1 7 0 UR 0 2 UR 3 0 0 0 0 2 0 0 0 0
Carotid PTA 9 0 UR 15 47 0 2 0 0 21 0 3 31 2 27 0 1 8 2 28 1 2 5 90 1 15 0 9 UR 0 0 0 0 0 10 0 0 0 0
Total nr. of stents in peripheral PTA 80 0 UR 5 188 1 7 2 18 78 4 39 232 156 59 35 29 0 8 45 12 12 19 137 9 UR 72 15 UR 13 0 5 0 0 13 0 0 0 1
Peripheral angiography 475 70 UR 141 869 48 158 52 540 24 34 185 220 323 56 170 385 108 78 57 94 96 140 466 11 UR 80 163 UR 102 328 73 1 46 174 10 21 0 24
Other interventions
TAVI 177 29 3 6 13 0 0 0 33 74 0 0 107 0 0 0 47 0 0 66 0 2 0 44 3 0 42 0 UR 0 60 0 0 0 0 0 0 0 0
MitraClip 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 UR 0 0 0 0 0 0 0 0 0 0
Aortic endoprostheses 4 0 0 0 12 0 0 0 4 1 0 0 16 0 0 0 15 0 0 24 0 0 0 19 1 0 24 12 UR 3 3 0 0 0 0 0 0 0 0
Interventions in structural heart disease4 24 12 0 3 10 0 0 0 1 32 0 5 8 0 8 0 0 5 0 73 0 0 0 12 1 0 0 0 UR 0 3 0 0 0 0 0 0 0 0

1 Total number of elective and urgent PCIs

2 It will represent the ratio between the total number of implanted stents and the total number of patients undergoing PCI

3 Number of peripheral angioplasty (lower and upper limbs artery, not including carotid arteries)

4 Interventions in cardiac structural diseases: percutaneous closures of DSA, DSV, PFO, arterial duct, balloon valvulotomies, left atrial appendage closure (PCI - percutaneous coronary intervention, STEMI - ST segment elevation myocardial infarction, DES – drug eluting stent, BVS - bioresorbable vascular scaffold, FFR - fractional flow reserve, IFR - instantaneous wave-free ratio, IVUS – intravascular ultrasound, OCT - optical coherence tomography, PTA - percutaneous transluminal angioplasty, TAVI - transcatheter aortic valve implantation)

The annual number of PCIs in every interventional cardiology center from Romania is represented in Figure 1. A direct comparison of data from 2014 to 2021 was completed, highlighting the continuous increase of workload of the interventional cardiology centers from Romania until 2021 when we have a clear decrease (Figure 2). In 2021, the number of PCIs increased, approaching the number of the pre-pandemic era. In 2021, in Romania, 19862 PCIs were performed compared to 15879 in 2019, that represent an increase by 25%. The total number of primary PCIs increased in 2021 with 10.8% compared to 2020 (Figure 3).

Figure 1

Total number of PCIs in 2021 in all interventional centers from Romania (PCI: percutaneous coronary intervention)

Figure 2

Total number of percutaneous coronary interventions from 2014 to 2021 in Romania.

Figure 3

Total number of primary PCIs in STEMI patients from 2015 to 2021 in interventional centers from Romania (PCI: percutaneous coronary intervention; STEMI: ST segment elevation myocardial infarction)

Although the total number of peripheral angioplasties doubled from 2014 to 2018, in 2019 there was a decrease in this regard by 13%, further decreasing in 2020 by 38% compared to 2019 (Figure 4). However, in 2021, 1695 peripheral angioplasties were performed, marking a 52% increase.

Figure 4

Total number of peripheral angioplasties from 2014 to 2021 in Romania (only in interventional cardiology centers)

The number of TAVI procedures doubled every year between 2015–2019, and the trend was maintained in 2021 with an increase of 43% compared to 2020 (Figure 5). The number of procedures performed in structural heart diseases increased from 2020 to 2021 by 15.2% (Figure 5).

Figure 5

Total number of TAVI and interventions in SHDs performed from 2017 to 2021 in Romania (TAVI - transcatheter aortic valve implantation, SHDs – structural heart diseases)

There is a continuous need for the implementation of a Mandatory Interventional Cardiology National Registry capable of objectively monitoring these key healthcare services in a standard manner. This national registry can guide further development of interventional cardiology in Romania1,2,3,4,5,6.

eISSN:
2734-6382
Sprache:
Englisch
Zeitrahmen der Veröffentlichung:
4 Hefte pro Jahr
Fachgebiete der Zeitschrift:
Medizin, Klinische Medizin, Allgemeinmedizin, Innere Medizin, Kardiologie, Kinder- und Jugendmedizin, Kinderkardiologie, Chirurgie, Herzchirurgie