Radial Force Group > Information
Introduction
The femoral artery, the traditional entrysite, is the most appealing approach for coronary angioplasty because of ease of arterial cannulation and catheter manipulation. However, there are several important limitations associated with this entrysite. The femoral artery usually runs deep under the skin, especially in obese patients, close to the femoral vein and nerve. Following removal of the arterial sheath one has to strike a balance between proper anticoagulation and hemostasis. In an era in which a range of potent new antiplatelet agents is administered in combination with heparin and thrombolytics just prior to, during or following angioplasty, bleeding complications are difficult to prevent, despite careful hemostasis techniques and prolonged immobilization of the patient.


On the contrary the radial artery is a potentially safer entrysite for several reasons.The superficial course of this artery facilitates hemostasis, by simple application of a pressure bandage over the puncture site. Important bleeding is immediately noticed by the patient, who can at least temporarily address this problem by himself. This is one of the reasons that blood loss is usually minimal. Since the median nerve is well separated from the artery, this structure is usually not damaged during puncturing or during bleeding. The absence of major veins, makes the incidence of arteriovenous fistula rare.

One of the most striking advantages is the free and immediate ambulation of the patient, which is greatly appreciated in most instances. Free mobilization, without additional risk for bleeding, opens the way to outpatient coronary angioplasty, reducing costs and increasing efficiency of coronary angioplasty and patient comfort. Waiting lists can be shortened, by increased turn-over on the cardiology ward.

This technique was pioneered by Lucien Campeau for diagnostic coronary studies. We adapted the transradial approach for coronary angioplasty and stenting, by combining miniaturized angioplasty equipment compatible with the small size of the radial artery. In august 1992 the first patients were treated via this route at the Amsterdam Department of Interventional Cardiology (ADIC) of the Onze Lieve Vrouwe Gasthuis (OLVG) in Amsterdam.

However, this transradial coronary angioplasty technique appeared to be technically more demanding compared to the traditional femoral technique, since smaller guiding catheters have to be used. In addition, these catheters are approaching the coronary arteries from the right side instead of the left side making adequate coronary cannulation a greater challenge. Downsized angioplasty equipment has to be selected, requiring more delicate handling. Anatomy of the arm and subclavian arteries is less well known and can provide surprising obstacles.

The price to pay for this safe and elegant technique is a new learning curve. Dependent on the current operator technique (brachial versus femoral, 6 French versus 8 French) one has to learn many new manoeuvers and tricks to obtain the best angioplasty results. Once the learning curve is over, one will notice that transradial procedures will take no longer than transfemoral procedures. The reward of this effort will be apparent after the procedure, since no manpower is required to obtain hemostasis and since bleeding complications are very uncommon.

Group Information
The RADIAL FORCE unites a group of interventional cardiologists, who have adapted a technique to perform coronary angioplasty via the radial artery, instead of the femoral artery. Practitioners who are using this technique as a routine are impressed by the safety, effectiveness and patient friendliness. More physicians are appealed by this approach, but the need to complete a new learning curve forms the most frequently heard objection to master this technique. However, at present there is enough knowledge and technical support, to pave the road for interested colleagues and to disseminate this technique broadly. The presence of an professional and enthousiastical working group is a first prerequisite is to further spread out the technique. The most appealing communication tool, open for anyone who wants to know more on the most recent advantages, is the Internet.
Aims
Because of the benefit of transradial coronary angioplasty for patients, cardiology departments and financers, this technique deserves a wide application.

However, some problems have to be overcome since transradial coronary angioplasty is a bit more complex and delicate and requires completion of a learning curve. Today there are  well structured teaching programs. Since the technique requires different materials, strong embracement by the industry is required.

The RADIAL FORCE brings together the specialists of the transradial approach of the world to bundle their expertise in order to expand the application of this technique in interventional practice.

Hospitals performing transradial coronary procedures
Although the number of centers performing transradial coronary procedures is much larger, the centers mentioned in this list have identified themselves as such.

Please fill out the application form, and your center will be added to this list.

 

Argentina
Instituto Cardiovascular San Luis / San Luis
Instituto Patagonico Cardiovascular / Buenos Aires
Hospital Aeronaútico Central Buenos Aires / Gral Pacheco
Instituta de Cardiologia de Santiago del Estero / Santiago del Estero
          Sanatorio Modelo Quilmes /   Buenos Aires
Sanatorio IPAM. Rosario / Santa Fe
          Hospital Centenario de Rosario / Santa Fe
Instituto Cardiovascular Denton A Cooley / Buenos Aires
Sanatorio Britanico / Rosario
Hospital de Alta Complejidad de Formosa / Formosa
Privado del Sud / Bahia Blanca
 
Australia
Sydney Adventist Hospital / Clareville
Prince Charles Hospital / Brisbane
Royal Perth Hospital / Perth
John Hunter Hospital / Newcastle
The Geelong Hospital / Geelong
Prince of Wales Hospital / Sydney
Monash Medical Center / Melbourne
          Western Hospital / Footscray
Cairns Base Hospital / Cairns
Cardiovascular Investigation Unit, Royal Adelaide Hospital / Adelaide
Fremantle Hospital / Fremantle

Austria
LKA / Salzburg
AKH Wels / Wels
Belgium
Hartcentrum Virga Jesseziekenhuis / Hasselt
Antwerp Cardiovascular Institute Middelheim . Antwerp

Brasil
Santa Casa de Juiz de Fora-Hospital Sao Lucas, Juiz de Fora
Cedip-Hospital das Nações / Curibita
Hospital Sao Vicente de Paulo / Rio de Janeiro
UDI Hospital / Sao Luis
Hospital de Clinicas de Porto Alegre / Porto Alegre
          Hospital Procordis - Niterói / Rio de Janeiro
Instituto do Coração Rio Preto / Sao Jose do Rio Preto
          Hosp. Benef. Portugeasa / Sao Jose do Rio Preto
Hospital Fornecedores de Cana / Piracicaba
          Hospital Memorial Sao Jose / Recife
Unicordis / Recife
Hospital Sao Francisco de Cardiologia e Transplantes / Porto    Alegre
Instituto do Coração do Triangulo / Uberrlândia
          Santa Casa de Misericordia de Araraquara / Sao Paolo
          Hospital Clementino Fraga Filho / Rio de Janeiro
          Hospital Santa Cruz, Sao Paolo
          Hospital do Coração- Secor / Curitiba
          Hospital Sao Lucas da Pucrs / Porto Alegre
          Hospital Sao Lucas / Aracaju
          Instituto Urabense de Cardiologia Invasiva / Uberaba
          Hospital Sao Marcos / Teresina
Felicio Rocho e Socor / Belo Horizonte
Biocor Hospital / Belo Horizonte
Instituto do Coração / Santa Casa de Marilia / Marilia
Clinica Sao Vincente / Rio de Janeiro
Memorial São José Hospital / Recife
          São Lucas Da Puc / Porto Alegre
UDI Hospital São Luis / Maranhão
Hospital Memorial / São Francisco
Hospital CardioTrauma Ipanema / Rio de Janeiro
Instituto do Cardiologia-RS and Cirecors-HED / Porto Alegre
Sao Jose do Avai Itapreuna / Rio de Janeiro
          Instituto de cardiologia / Vitoria
          Hospital de Cardiologia de Laranjeiras / Rio de Janeiro
          Albert Sabin / Juiz de Fora
          Santal Luzia Hospital / Brasilia
          São Vicente de Paulo / Rio de Janeiro
          Hospital Mémorial Petrolina / Petrolina
Hospital Adventista Silvestre / Rio de Janeiro
          Instituto de Molestias Cardiovascular / Sao Jose do Rio Paulo
Procardio / Sao Luis
          Angiocordis - Santa Casa de Limeira / Limeira
Hospital Ana Costa Santos / Sao Paulo
ITC-Novo Hamburgo / Porto Alegre
Incor-Campinas / Sao Paolo
          Santa Joana Hospital / Reife
Santa Catarina / Blumenau
Hospital Universitario Pres. Dutra / Sao Luis
Hospital Universitario Pedro Ernesto-HUPE / Rio de Janeiro
          Hospital Universitario Evangelico de Curitiba / Curitiba
Clinica Cardiologyca C. Costantini / Curitba
          Hospital Ana Costa - Santos
Instituto do Coração - Sao Paulo
          Instituto do Coração de Franca - Franca
Hospital de Clinicas de Niteroi - Rio de Janeiro
          Hospital de Coracao de Londrina / Londrina
Hospital das Clinicas-UNESP / Botucatu
          Centro de Cardiologia do HSD / Sao Luis
Hospital Santa Joana / Recife
Bebeficencia Portuguesa / Sao Paolo
Intervent / Cascavel
Cuore-Incor / Itajai
 

Bulgaria
Clinic of Invasive Cardiology; Higher Institute of Medicin / Plovdiv
          Clinic Hospital Lozenetz / Sofia
National Heart Hospital - Sofia
Canada
Queen Elizabeth II Health Sciences Centre / Halifax
Institut de Cardiologie de Montréal / Montréal
The Montréal General Hospital / Montréal
Hôpital Laval / Québec
Capital Health Region / Victoria
Royal Jubilee Hospital / Victoria
          Centre Universitaire de sante de l'Estrie / Sherbrooke
Cuse Fleurimont / Fleurimont
          Royal Columbia Hospital / New Westminster BC
          Hopital du Sacre Coeur / Mont-Royal / PQ
Royal Alexandra Hospital / Edmonton / Alberta
St. John Regional Hospital / Rothesay
          St. Michael's Hospital / Toronto
          Ottawa Heart Institute / Ottawa / Ontario
CH de la Sagamie / Chicoutimi
Sunnybrook and Women's College Health Sciences Centre / Toronto
Hôtel-Dieu de Montréal / Montréal
Hamilton Health Sciences / Hamilton
University of Alberta / Edmonton
St. Mary's General Hospital / Kitchener
         
Czech Republic
University Hospital Olomouc / Olomouc
Kardiocentrum Nemocrice Podlesí / Trinec
          University Hospital Motol / Prague
          Municipal Hospital Ostrava / Ostrava
University Hospital / Hradec Kralove
IKEM / Prague
University Hospital Brno-Bohunice / Brno
 
Chile
          Clinica Las Condes Santiago / Santiago
Instituto Nacional del Tórax / Santiago
Hospital DIPRECA / Santiago
Clinica Alemana / Santiago
 
China
Queen Elizabeth Hospital / Kowloon, Hong Kong
          PLA General Hospital / Beijing
          Liaoning Provincial People's Hospital / Shenyang
          Nanjing First Hospital / Nanjing
First affeliated hospital Zhejang University / Hangzhou
          Henan Provincial Peoples Hospital / Zhengzhou
Beijing Anzhen Hospital / Beijing
          Pamela Youde Nethersole Eastern Hospital / Hong Kong
The 2nd hospital of Hebei Medical University / Shijiazhuang
Tangshan Gongren Hospital / Tangshan
Tuen Mun Hospital / Hong Kong
Drum Tower Hospital / Nanjing
Hong Kong Adventist Hospital / Hong Kong
Hong Kong Baptist Hospital / Hong Kong
         
Croatia
          Sveti Duh / Zagreb
 
Denmark
Aarhus University Hospital / Aarhus
          The Rigshospital / Copenhagen
   
          Egypt
TUH / Tanta
 
Finland
Helsinki University Hospital / Helsinki
          Central Hospital of Vaasa / Vaasa
          Tampere University Hospital / Tampere
          Satakunta Central Hospital / Pori
          Hospital Cordia / Kuopio
          North Carelia Central Hospital / Joenfuu
          Paijat-Hame Central Hospital / Lahti
 
France
Institut Jacques Cartier / Massy
Clinique Lavalette / Montpellier
Centre Hospitalier Universitaire / Montpellier
Hôpital Cochin / Paris
Hospital Bichat / Paris
Institut Mutualsite Montsouris / Paris
Hôpital Claude Galien / Quincy sous Senart
Clinique Pasteur / Toulouse
Ch. Valere Lefebre / Le Raincy
Clinique La Roseraie / Aubersville
Hospital Trousseau / Tours
Hospital of Lens / Lens
          Hospital Saint Philibert / Lomme
CH Mulhouse / Mulhouse
          Centre Cardiologique du Nord / Saint Denis
Clinique du Bois / Lille
Clinique du Bois de Verrieres / Antony
          CHU / Caen
          Hospital Lariboisiere / Paris
Hospital Antoine Beclere / Clamart
CMC Parly Grand / Chesnay
Clinique de Grand Large / Brest
          Clinique St. Augustin / Bordeaux
          Hôpital Henri Mondor / Créteil
          Pitié Salpétière / Meudon
CHI Le Rainy / Montfermeil
          Hopital du Val-de-Grâce / Paris
Hopital Europeen de la Rosaraie / Aubersvilliers
 
Germany
Klinik fur Angiologie / Essen
Paracelsus-Kurfuersten Klinik / Bremen
AK Barmbek, 1.Med.Dep. / Hamburg
Staedtische Kliniken Offenbach / Frankfurt
Staedtische Klinik / Oldenburg
Medical Clinic II, University Erlangen / Erlangen
Zentral Krankenhaus "Links der Weser" / Bremen
          Robert Koch Krankenhaus / Gehrden
Diakonie Krankenhaus / Rotenburg (Wuemme)
          St. Marienkrankenhaus / Siegen
University Hospital Herne / Bochum
          UK Eppendorf / Hamburg
          Universitätsklinik Freiburg / Freiburg
          Medizinische Universitätsklinik / Würzburg
          Staedtisches Klinikum / Brandenburg
          Staetische Kliniken Frankfurt am Main / Frankfurt
          Marien Hospital / Gelsenkirchen
          Evangelischen Krankenhaus / Düsseldorf
          Kardiologische Gemeinschaftspraxis / Bremerhaven
          Diako Flensburg / Flensburg
          Klinikum Kempten Kardiologie / Kempten
          Kardiologische Praxis / Mainz
Klinikum Minden / Minden
Klinikum Saarbruecken / Saarbruecken
Hertzzentrum Bad Krozingen / Bad Krotzingen
          Zentralklinik Bad Berka / Bad Berka
Alg. Krankenhaus Hagen / Hagen
          Klinikum Hoyerswerda / Hoyerswerda
Vivantes Klinikum im Friedrichshain / Berlin
          Cardiovascular Hospital / Dresden
St. Marienhospital / Vechta
Kardiologische Praxis Schwabing / Munich
Cardiology Bogenhausen / Munich
Schwerpunktpraxis Kardiologie-Angiologie Rehabilitation / Bonn
Vivantes Klinikum am Urban / Berlin
Katholisches Krankenhaus / Hagen

         Greece
         
Ahepa / Thessaloniki
         1st IKA Hospital / Athens
          Laikon Hospital / Athens         

          Hungary
          Albert Szent - Györgyi Medical University / Szeged
          University of Szeged / Szeged

India
Sion Medical College and Hospital / Mumbai
CTC / New Delhi
          Mediciti Hospital / Hyderabad
          Peerless Hospital / Calcutta
          King Edward VII Memorial Hospital / Mumbai
          Seven Hills Hospital / Visakhapatnam
Santokba Durlabhji Hospital / Jaipur
          GKNM hospital / Coimbatore
SMS Hospital / Jaipur
Yashoda Hospitals / Hyderabad
          Maharaja Agrasen Hospital / West Delhi
Escorts Heart Institute / New Delhi
          Mahaveer Hospital - Hyderabad
SG PGI Lucknow - Kanpur
          Krishna Heart Insitute - Ahmedabad
Ruby Hall Clinic / Pune
Sri Ramachandra Medical College and Research Institute / Salem
          Usha Mullapudi Cardiac Center / Hyderabad
Sardar Patel Hospital / Bikaner
Apollo Hospitals / Hyderabad
          JJ Hospital / Mumbai
Sterling Hospital / Ahmedabad
          Kims / Hyderabad
Apollo Gleneagles Hospitals / Kolkata
          Sal Hospital / Ahmedabad
King George Medical University / Lucknow
Sut Hospital / Trivandrum
Lilavati Hospital and Research Center / Mumbai
Amrita Institue of medical sciences / Kochi
Bil Nair Hospital / Mumbai
Lifeline Rigid Hospital / Chennai
Wockhardt Heart Hospital / Hyderabad
Apollo Hospital / Madurai
V.S. Hospital / Hyderabad
Hymalaian Hospital / Dehradun
Yashoda hospital / Hyderabad
Nizam Institute of Medical Sciences / Hyderabad
International center for cardiothoracic and vascular diseases / Chennai
Heart Clinic Moorthys Hospital / Trichy
Sri Ramachandra Medivcal College & Research Institute / Chennai
Hero-DMC Heart Institute / Ludhiana
Wockhardt Heart Hospital / Nagpur
Eaternal Heart Care Center S.K. Soni Hospital / Jaipur
Arneja Heart Institute / Nagpur
Davangere Heart Hospital / Davangere
PBM Hospital / Bikaner
 
Indonesia
National Cardiovascular Center / Jakarta
          Ciptomangunkusumo National General Hospital - Jakarta
Gatot Soebroto Army Center Hospital / Jakarta
 
Iran
Tehran Heart Institute / Tehran
Biagiatallah, Rajali, Jamaran / Tehran
          Tehran Heart Center / Tehran
 
Israel
Hadassah University Hospital / Jerusalem
Rabin Medical Center / Petah Tiqva
Hillel Yaffe Medical Center / Hadera
Shaare Zadek Medical Center / Jerusalem
Soraka Medical Center / Beer Sheva
 
Italy
Ospedale di Legnano / Legnano
Centro Cuore Columbus / Milano
Policlinico A. Gemelli / Rome
S. Anna Hospital / Como
          Mauriziano Hospital / Torino
Cliniche Gavazzeni, Bergamo / Milano
          Ospedale Piemonte / Messina
General Hospital / Bolzano
Ospedale Reuniti / Bergamo
Cardiothoracic Department - University of Pisa / Pisa
Clinica Mediterranea / Salerno
Ospedale "A. Manzoni" / Lecco
Gioivanni Bosco Hospital / Torino
Ospedale Maggiore / Bologna
Hospital Piacenza / Piacenza
S. Camillo Hospital / Rome
Cardiothroracic Department / Pisa
          Policlinico S. Orsola / Bologna
          Poliambulanza Hospital / Brescia
          Maria Vittoria Hospital / Torino
          Ospedale di Circolo / Milano       
          Arcispedale S. Maria Nouva / Reggio Emilia   
Ospedale S. Gerardo / Monza
          Casa Sollievo della Sofrenza Hospital / San Giovanni Rotondo
Sandro Pertini / Roma
          Policlinico Umberto I Roma / Roma
Ospedale Loreto Mare / Napoli
Ospedale Riuniti / Livorno
          Ospedale Carlo Poma / Mantova
Ospedale Mater Salutis / Legnago
 
Japan
Shonan Kamakura General Hospital / Kamakura
Osaka Red Cross Hospital / Osaka
Kurashiki Central Hospital / Kurashiki
Teikyo University Hospital / Tokyo
University of Tokyo School of Medicin / Tokyo
Tokeidai Hospital / Sapporo
Hokkaido University Hospital / Sapporo
Yahata Hospital / Kitakyushu
Fuchu-iou Hospital / Tokyo
Osaka National Hospital / Osaka
Kitakyushu City Yahata Hospital / Kitakyushu
Sakae Kyosai Hospital / Yokohama
Sendai Kousei Hospital / Sendai
          Funabashi Municipal Medical Center / Funabashi
National Hakodate Hospital / Hakodate
          Kanazawa Cardiovascular Hospital / Kanazawa
Kyoto Min Iren Central Hospital / Kyoto
Cardiovascular Division Nagasaki University Hospital / Nagasaki
Hachinohe City Hospital / Hachinohe
          Seiwa Hospital / Yamato City
          Jikei University Daisan Hospital / Tokyo
          Tokyo Metropolitan Geriatric Hospital / Tokyo
          Fukui Cardiovascular center / Fukui
          Kasukabe Central general Hospital / Koshigaya
Kumamoto Rousai Hospital / Yatsushiro
          Harasanshin General Hospital / Fukuoka
Oital Oka Hospital / Oita
Takahashi Hospital / Kobe
Shonai Amarume Hospital / Yamagata
          Akiru Municipal General Hospital / Tokyo
          Kishiwada Tokusyokai Hospital / Kishiwada
          Maizuru Kyosia Hosiptal / Maizuru
          Takahashi hospital / Kobe
          Toki Municipal Hospital / Toki
          Rinku General Medical Center / Osaka
          Osaka City General Hospital / Osaka
          Asahi General Hospital / Asahi
          Hyogo College of Medicine / Nishinomiya
Municipal Second Hospital Otaru / Otaru
Moulana Hospital / Perinthalmanna
MIOT Hospital / Chennai
King George Medical University / Lucknow
        
Latvia
P. Stradins Clinical University Hospital - Riga
 
Lebanon
North Medical Center / Zgharta
 
          Korea
         
Pusan National University Hospital / Pusan
          Kangdong Sacred Heart Hospital / Seoul
          Gyeong-Sang national Hospital / Jinju
          Kocin Medical Center / Busan
          Wallace Memorial Baptist Hospital / Pusan
Korea University Hospital / Seoul
Yonsei Cardiovascular Hospital / Seoul
 
Macedonia
Institute for Heart Diseases / Skopje
Cardiac Surgery Filip II / Skopje
 
Malaysia
National Heart Institute / Kuala Lumpur
University Hospital / Kuala Lumpur
Subang Jaya Medical Centre / Subang Jaya
Damai Medical & Heart Clinic / Melaka
Institut Jantung Negara / Kuala Lumpur
Penang Hospital / Penang
          Loh Guan Lye Specialist Centre / Penang
          Hospital USM / Kubang Kerian
Gleneagles hospital / Kuala Lumpur
University Malaya Medical Center / Kuala Lumpur
Hospital Pulau Pinang / Georgetown
 
Mexico
Hospital 10 de Octubre / Mexico
          Regional de Premex/CD Madero / Tamaulipas
          Hosp. Gen. Dr. Norberto Trevino Zapata / Ciudad Victoria
Instituto Nacional Ciencias Medicas y Nutricion Salvador Zubiran / Mexico City
Hospital General de Puebla / Puebla
Centro Medico La Raza / Mexico City
Hospital Jardines de Guadelupe / Guadalajara
Hospital Star Medica / Merida
Hospital Amerimed / Los Cabos
San Javier Marina / Puerto Vallarta
The Netherlands
Academisch Ziekenhuis Utrecht / Utrecht
          Catharina Ziekenhuis / Eindhoven
Onze Lieve Vrouwe Gasthuis / Amsterdam
Bronovo Hospital / Denhaag
Medisch Centrum Alkmaar / Alkmaar
          Spaarne ziekenhuis / Heemstede
West Fries Gasthuis / Hoorn
VU Medisch Centrum / Amsterdam
 
New Zealand
Waikato Hospital / New Zealand
Ascot Hospital / Auckland
Wellington Hospital / Wellington
Christchurch Hospital / Christchurch
Mercy Angiography Unit / Auckland
 
Nigaragua
Centro National de Cardiologia / Managua

          Norway
            
Feiring Heart Clinic / Feiring
          Ulleval Hospital / Oslo
          Rikshospitalet / Oslo

Pakistan
Punjab Institute of Cardiology / Lahore
National Institute of Cardiovascular diseases / Karachi
The Aga Khan University Hospital / Karachi

          Peru
         
C.H. San Pablo / Lima

          Poland
         
3rd Department of Cardiology / Katowice
          University Hospital / Lublin
          Central Hospital of Warsaw Medical University / Warsaw
          Szpital Specjalistyczny sw Wojciecha-Adalberta
Central Military Hospital / Warsaw
Central Clinicl Hospital of Ministry of Internal Affairs / Warsaw
          Bielanski Hospital / Warsaw
Medical University of Gdansk / Gdansk
 
          Portugal
          Hospital de Santa Maria / Lisbon
Hospital Distrital de Faro / Faro
Hospital Santi António / Porto
Centro Hospitalar de Coimbra / Coimbra
Hospital Universidade Coimbra / Coimbra
Hospital Garcia de Orta / Almata
Hospital de Sao Bernardo / Setubal
Republic of Korea
Wonju College of Medicin / Wonju
Dong-A University Hospital / Pusan

          Republic of Macedonia
         
Institute for Heart Disease / Skopje

Romania
Cardiology Center? / Timisoara
         
Russia
Center of endosurgery, Dpt of invasive cardiology / Moscow
National Research Center for preventive medicin / Moscow
Saratov Heart Research Center /  Saratov                                          
          Cardiology Research Complex / Moskow
         
Saudi Arabia
Prince Sultan Cardiac Center / Riyadh
Dallah Hospital / Riyadh
Armed Forces Hospital / Jeddah
Prince Sultan Cardiac Center / Burayda

          Scotland
         
Monklands Hospital / Airdrie

Serbia
Institute for Cardiovascular Disease Dedinje / Belgrade
 
          Singapore
         
National Heart Center / Singapore
Changi General Hospital / Singapore
 
          South Africa
         
Wilgers Hospital / Pretoria
Sunninghill Hospital / Johannesburg
Tygerberg Academic Hospital / Cape Town
 
Spain
Miguel Servet. Zaragoza / Zaragoza
          Clinica Universitaria Pamplona / Pamplona
Clinica Universitaria de Navarra / Pamplona
ClinicoUniversitario de Santiago / Santiago
          Clinica de Recoletas / Albacete
          H. Virgen de las Nieves / La Zubia
          Clinica Virgen de Guadelupe / Cáceres
Hospital Juan Caneljo / A Coruña
Virgen del Rocio / Sevilla
Hospital do Meixoeiro / Vigo
La Princesa / Madrid
          Hospital Universitari Germans Tria I Pujol / Badalona
Hospital Meixoeiro Vigo / Vigo
Hospital Universitario Juan XXIII de Tarragona / Tarragona
Hospital de Galdakao / Galdacano
          Hospital San Jaime / Torrevieja
Universitary Miguel Servet / Zaragoza
          Hospital Universitario La Paz / Madrid
Hospital del Mar / Barcelona
          Santa Cruz y San Pablo / Barcelona
Juan Ramon Jimenez / Huelva
Torrecardenas / Almeria
Hospital Vall d'Hebron / Barcelona
Virgen de la Arrixaca / Murcia
Hospital Universitario Son Dureta / Palma de Malloca
Hospital Clinico Universitario / Valencia
Hospital Torrevieja Salud / Alicante
 
          Sweden
         
Akademiska Sjukhuset / Uppsala
          University Hospital / Linköping
          BLS Karlskrona / Karlskrona
          Södersjukhuset / Stockholm
          Umeå University Hospital / Umeå
          Länsskukhused Gäule / Gärleborg
Orebro University Hospital / Orebro
          Switzerland
          University Hospital Geneva / Geneva
 
          Taiwan
         
China Medical College Hospital / Taichung
          Tri-Service General Hospital / Taipei
          Chang Gung Hospital / Taipei
          Show Chwan Memorial Hospital / Changhua
          Veterans General Hospital / Taichung
          Chi-Mei Foundation Hospital / Yeong Kang
          En Chu Kong Hospital / Taipei
          Chang Gung Memorial hospital / Kaohsiung
          Cheng Chin Hosptal / Taichung
          Taipei Veterans General Hospital / Taipei
          Cathay General Hospital / Taipei
          Chang Gung Memorial Hospital / Guei-Shan
Changhua Christian Hospital / Changhua
          Chang Gung Memorial Hospital / Chia-Yi
 
Thailand
Maharaj Nakorn Chiang Mai Hospital
          Chulalongkorn Hospital / Bangkok
Siriraj Hospital / Bangkok
          Saint Louis Hospital / Bangkok
Bhumibol Adulyadej Hospital / Bangkok
Tunesia
Policlinique Taoufik / Tunis
Mongi SLIM University Hospital / La Marsa
         
Turkey
Bayindir Medical Center /Ankara
          Dokuz Eylul University School of Medicin Inciralti / Izmir
Baskent University / Adan
Alman Hastanesi / Istanbul
 
United Kingdom
St. George's Healthcare NHS Trust / London
King's College Hospital / London
Papworth Hospital / Papworth Everard
North Staffordshire Hospital / Stoke on Trent
Birmingham Heartlands Hospital / Birmingham
Glenfield Hospital / Leicester
St. Thomas Hospital / London
Royal Berkshire and Battles Hospitals / Reading
Blackpool Victoria Hospital / Blackpool / Lancs
Derriford hospital / Plymouth
          Hairmyres hospital / Kilbride
          St. Bartholomew's Hospital / London
Eastbourne SMS trust / Eastbourne
Hull Royal Infirmary / Cottingham
Castle Hill Hospital / Cottingham
          Manchester Heart Center / Manchester
New Cross Hospital / Wolverhampton
          RusselsHall Hospital / West Midlands
Royal Victoria Hospital / Belfast
          Derriford / Plymouth
North Middlesex University Trust Hospital / London
Russels Hall Hospital / Dudley
Bradford Royal Infirmary / Bradford
The Heart & Lung Unit / Torquay
Cardiothoracic Centre Liverpool NHS Trust / Liverpool
The James Cook University Hospital / Middlesbrough
Hull Royal Infirmary / Brough
Morrison Hospital / Swansea
Royal Bournemouth Hospital / Bournemouth
 
United States of America
St. Johns Hospital / Springfield / Illinois
Boston University School of Medicin / Boston, MA
Morton Plant Hospital / Clearwater, Florida
Ft. Wayne Cardiology / Ft Wayne, Indiana
Methodist Hospital / Merilville, Indiana
St. Luke's and St. Francis Hospitals / Milwaukee, Wisconsin
Milwaukee Cardiovascular Research Foundation / Milwaukee, Wisconsin
Cardiology Consultants of Philadelphia / Moorestown
Wake Heart Center / Raleigh, North Carolina
Medical College of Ohio / Toledo
Hans Hecht Cath Lab, University of Chicago / Chicago
Carle Heart Center / Urbana, IL
Freeman Health System / Joplin, MO
Center for Heart Sciences / Toledo, Ohio
Medical College of Georgia / Augusta, Georgia
Brookwood Medical Center / Birmingham, AL
Providence Hospital / Columbia, SC
St. Thomas Hospital / Nashville, Tennessee
St. Vincent's Medical Center of New York / NY
Erie County Medical Center / Buffalo / NY
Long Island Jewish Medical Center / NY
Bergan Mercy Medical Center / Omaha, Nebraska
Columbia Lakeview Hospital / Bountiful, Utah
Harbor-UCLA Medical Center / Torrance / CA
Good Samaritan Hospital / Kearney / NE
Resurrection Medical Center / Chicago / IL
Holy Familiy Medical Center / Des Plaines / IL
O'Connor San Jose / Cupertino / USA
St. Francis / Beech Grove / IN
Redmond Regional Hospital / Rome / GA
Union Memorial / Baltimore / Maryland
University of Conneticut / Conneticut
Baylor University Medical Center / Dallas / Texas
Medical Center East / Birmingham / AL
Vanderbilt University Medical Center / Nashville / TN
Mc Cuistion Regional Medical Center / Paris / TX
Saint Francis Hospital and Medical Center / Hartfort, CT
Pascack Valley Hospital / Westwood / NJ
          St. Alphonsus / Boise / Idaho
Greenville Memorial / Greenville / SC
St. Josephs Hospital / Milwaukee / Wisconsin
          John Muir Medical Center / Walnut Creek / CA
Providence Hospital / Portland / OR
          The Lankenau Hospital / Wynnwood / Pennsylvania
William Beaumont Hospital / Royal Oak / MI
          Pitt County Memoroial Hospital / NC
Moore Regional / Pinehurst / NC
          Saint Louis University / Saint Louis / MO
The University of Texas Health Center of Tyler / Tyler / TX
          Marin General Hospital / Greenbrae / CA
St. Charles Medical Center / Bend / OR
          The Queen's Medical Center / Honolulu / HI
Deborah Heart and Lung Center / Browns Mills / NJ
          Waukesha Memorial Hospital / Waukesha / MI
          St. Joseph's Hospital / Syracuse / NY
          Baylor University Medical Center / Dallas
          Norton Hospital / Louisville / KY
Seton Medical center / Daly City / CA
Baptist Hospital / Nashville / TN
Hershey Medical Center / Hershey / PA
Mount Carmel Medical Center / Columbus / Ohio
Stanford University Medical Center / Stanford / CA
          University of Texas Health Center / Tyler / TX
John Hopkins Hospital / Baltimore / Maryland
Desert Springs Hospital / Las Vegas / NV
St. John's Mercy Medical Center / St. Louis / MO
University Clinic of Ct. / Farmington / Ct
          Salinas Valley Memorial Hospital / Salinas / CA
          Memorial Hospital / South Bend / IN
Ocala Regional Medical Center / FL
Beauregard Memorial Hospital / DeRidder / LA
Lynchburg General Hospital / Lynchburg / VA
Dameron Hospital / Stockton / CA
St Joseph Orange / Irvine / CA
Swedish Hospital Medical Center / Mercer Island / WA
Enloe Hospital / Chico / CA
Maryview Hospital / Chesapeake / VA
Sentara Norfolk General Hospital / Chesapeake / VA
          Davis Hospital and Medical Center / North Salt Lake / UT
Swedish Hospital and Medical Center-Seattle / Mercer Island / WA
Mercey Hospital Medical Center / Des Moines / IA
UC Davis Medical Center / Sacramento / CA
Naples Community Hospital / Naples / FL
St. Mary's Hospital / Rochester / MI
Blake Medical Center / Bradenton / FL
Sunrise / Desert Springs / NV
Kenosha Hospital and Medical Center / Wisconsin / WN
Denbury Hospital / Danbury / CT
          St. Mary's / Madison / WI
          Scripps Memorial Hospital / La Jolla / CA
Regional Medical Center / Longview / TX
          University of Conneticut / Farmington / CT
North Memorial Medical Center / Minneapolis / MN
St. Francis Hospital / Memphis / TN
St. Joseph's Hospital Syracuse / Fayetteville / NY
Integris Bass / Enid / OK
Good Samaritan Regional Medical Center / Phoenix
Longmont United Hospital / Longmont / Colorado
York Hospital / York / PA
Park Ridge Hospital / Park Ridge / IL
Milwaukee cardiovascular Center / Milwaukee
Mercy Hospital / Buffalo / NY
          Longview Medical Center / TX
Hermann Hospital / Houston / TX
Oregon Cardiology Diagnostic Center / Eugene / Oregon
Cardiology, Inc. / Columbus / Ohio
          Saint Vincent's Medical Center of NY / NY
Sacred Heart Medical Center / Eugene / OR
          Rex Healthcare / Raleigh / NC
Northwest community hospital / Des Plaines / Ill
          Mercy Hospital & Community Medical Center / Scranton PA
Skagit Valley Hospital / Mount Vernon / WA
Exempla Saint Joseph Hospital / Denver / Colorado
Lahey Clinic / Burlington / MA
Kennestone Wellstar / Marietta / GA
The Miriam Hospital / Woonsocker / RI
Spartanburg Regional  Hospital / Spartanburg / SC
Mount Carmel Medical Center / Columbus / Ohio
St. Joseph's Hospital and Northside Hospital / Atlanta / GA
Loma Linda University Hospital / Loma Linda / CA
Rapid City Regional Hospital / Rapid City / SD
Durham VA Medical Center / Durham / NC
Wellstar Kennestone Hospital Marietta / Marietta / GA
 
Uruguay
Incor-Acociacion Espagnola / Montevideo
Instituto Nacional de Cirurgia Cardiaca / Montevideo
 
          Venezuela
         
Instituto Medico La Floresta / Caracas
          Policlinica Metropolitana / Caracas
Hospital Universitario de Caracas / Caracas
          Centro Medico de Caracas / Caracas

         Vietnam
         
Vietnam Heart Hospital / Ha-noi