title: [Bypass surgery 1984: current state and future perspectives in Europe, especially in the Federal Republic of Germany].
abstract: The development of bypass surgery in Europe during the last 15 years is briefly reviewed; the slow start has to be attributed mainly to insufficient financing, allowing only university hospitals to perform this type of cardiac surgery in most of the countries of western Europe. In addition, in Europe in the late sixties many university hospitals did not have a division of cardiac surgery. This applies also to the FRG, where cardiac surgery had to be expanded considerably in the seventies. Finally, in the late sixties only relatively few diagnostic centers, i.e. catheterization laboratories were available. Places for coronary angiography in sufficient number had first to be created. The second half of the seventies and the early eighties showed a considerable, although still insufficient increase in surgical capacities as well as in cardiac diagnostic centers. Nevertheless, the proposed number of 300 bypass and 400 open heart operations per million population for the FRG will also not be achieved in 1985. This figure represents, however, an absolute minimum (in comparison: approximately 800 bypass operations/million population/year in the US). Furthermore, the necessary number of catheter and angiographic facilities to provide the screening of enough patients is also lacking. Based on an estimated number of 600 catheterizations per lab and per year, the number of catheter laboratories for adults would have to be increased by 30-50% in the FRG, depending on the area. Hence, in the FRG the situation is still critical with regard to the capacity of invasive revascularization (bypass surgery, balloon dilatation), if an adequate service in due time (revascularization within days or weeks rather than months) is to be available throughout the country. This, obviously, can only be achieved if cost-related financing is also introduced for university centers, and the money allocated for medicine, especially cardiology, is spent where and when it is most needed, i.e. in the acute, life threatening situation.
mesh_terms: D000787:Angina Pectoris / Q000601:surgery / Q000628:therapy; D000800:Angioplasty, Balloon; D006328:Cardiac Catheterization; D006348:Cardiac Surgical Procedures; D001026:Coronary Artery Bypass; D003327:Coronary Disease / Q000601:surgery / Q000628:therapy; D005060:Europe; D005544:Forecasting; D005860:Germany, West; D006349:Heart Valve Diseases / Q000601:surgery; D006801:Humans; D013223:Statistics as Topic; D014481:United States
vernacular_title: Bypass-Chirurgie 1984, gegenwärtiger Stand und Zukunftsperspektiven in Europa, insbesondere in der Bundesrepublik Deutschland.