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Bypass surgery can help severe heart patients to live longer
02/Oct/2006: According to a Duke University Medical Centre study, severe heart patients who undergo bypass surgery, as their primary treatment, live longer than those who undergo artery-opening angioplasty or other heart medications.
Most of the patients diagnosed with severe coronary heart diseases are treated with angioplasty or other medications, since bypass surgeries are expensive and invasive.
Bypass surgery is a surgical procedure carried out on patients with severe heart diseases, by bypassing the blockage in the coronary artery with healthy artery taken from another part of the patient’s body.
In angioplasty a catheter is introduced into the arterial system and pushed through the system to the location of blockage. A balloon is then introduced in to the catheter and is blown at the blockage, pushing the blockage against the wall of the artery, opening it.
Dr. Peter Smith, M.D, chief of cardiothoracic surgery and the lead investigator of the study said that even though angioplasty is lot cheaper than bypass surgery, it do not offer the survival benefits to the patients, which bypass surgery offers. He added that in spite of being the most invasive treatment option, bypass surgery, improves the longevity of patients suffering from severe coronary heart diseases.
Researchers involved in this study, which was supported by Duke Clinical Research Institute and Duke's Division of Cardiothoracic Surgery, analyzed the records of 18,481 patients who had at least one coronary artery that was more than 75% blocked and received angioplasty or heart medications or bypass surgery at Duke University Medical Centre in the period 1986 – 2000. Patients were considered to suffer from severe coronary heart disease, if three of their coronary arteries were more than 75% blocked.
The patients were divided in to three groups based on the periods in which they received their treatment: 1986-1990, 1991-1995 and 1996-2000. The last period is important because physicians first started using stents (an expandable wire or tube) in angioplasty procedures only in 1996. Stents help in preventing re-blockage of treated arteries and it is widely used in angioplasty procedures today.
The study found that severe heart patients, who received bypass surgery in the period 1996 -2000, lived an average 5.3 months longer than those who were treated with angioplasty.
Dr. Smith said that the findings of this study should change the current practice of preferring angioplasty over bypass surgery. He added that patients who receive angioplasty has to carry a foreign object (stent) in their body and should take drugs regularly to prevent clots in the stent, while those who receive bypass surgery gets a more durable fix to their disease.
Researchers also found that both angioplasty and bypass surgery provide more benefits to patients with severe heart diseases than medicines alone. Since this study covered many patients, who by and large represent the general population, Dr. Smith feels that results of this study should be widely applicable. The findings of this study appear in the October’s issue of the journal ‘Annals of Thoracic Surgery’.
K Siva
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