The optimal site for performing cardiac catheterization depends upon complications of the procedure, access to care in the event of complications, costs, quality of the catheterization studies, access to the procedure, and patient satisfaction. Performing ambulatory cardiac catheterization at or adjacent to a hospital may assume equivalent access to emergent or urgent services, equivalent quality, and improved patient satisfaction at reduced cost for low-risk patients (stable coronary symptoms, no active congestive heart failure, no significant arrhythmias, and no significant comorbid factor--bleeding diathesis, renal insufficiency, uncontrolled systolic hypertension). However, moving an outpatient catheterization from the hospital site to a free-standing unit, physically remote from a hospital, may be associated with a reduction in access to emergency care and less standardized quality assurance.
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