A Study to Assess the Acceptance of Doctors toward the Practice of Reusing of Cardiac Disposables in Coronary Angioplasty in a Tertiary Care Hospital

Abstract

Objectives: Health-care providers are expected to deliver quality patient care cost-effectively, especially in developing countries. Medical devices labeled “single use only” should ideally not be reused but, can be considered for reuse due to their higher cost. Stringently regulated reprocessing of the single-use device provides an opportunity to do so along with the potential to have a favorable impact on environmental waste. The aim of this study is to assess the acceptance of doctors toward the practice of reusing cardiac disposables in coronary angioplasty. Materials and Methods: An open-ended and self-designed questionnaire was prepared and was standardized by a panel of cardiologists to assess doctors’ acceptance toward reusing cardiac disposable in coronary angioplasty. The cardiologists were interviewed individually, and the responses were analyzed. Results: The cardiologists were aware that the angioplasty disposables were being reused. The majority were satisfied with the sterilization of disposables and were of the opinion that it was safe for the patients. Cardiac catheters were reused 5–6 times while the balloons were reused 3–4 times. An increase in procedure time of 10–15 min was observed in 30% of patients. There was an increase, in contrast, volume of about 40–50 mL with reused cardiac catheters and balloons which was observed in 15% of patients. Defect in the physical integrity of the catheter, that is, tip abrasion/microfracture was observed in 1% of patients. Deflation dysfunction of the balloon during the procedure was observed in 2% of patients, while breakage of the balloon from the shaft and entanglement of the balloon was observed in 1% of patients. Balloon rupture during angioplasty was observed in 8% of patients. Around 1.5% of patients undergoing angioplasty with reused disposables presented with infections. Thrombosis was observed in 3% of patients with reused disposables, and it was the most common adverse event post-angioplasty. There were cases where the patients were sent for emergency surgery/coronary artery bypass graft surgery due to balloon entanglement and about 0.1% of patients were found to have such a complication. Conclusion: Cardiac disposables can be safely reused by health-care professionals, especially in developing nations due to their budget constraints, provided it is reused no more than 3–5 times and efficient methods of sterilization are observed.