Word: bypassed
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When it was introduced 15 years ago it was hailed as the biggest medical breakthrough of the decade. Since then, bypass surgery has become the most commonly performed heart operation in the U.S. (170,000 last year). It is a $3 billion industry, and thanks to the news media, which have faithfully chronicled operations on such notables as Henry Kissinger, Alexander Haig, Rock Hudson and Arthur Ashe, it has even achieved a certain social cachet. The bypass boom has led some doctors to fear that the operation is being overused. Now a study funded by the National Heart, Lung...
...purpose of bypass surgery is, quite literally, to find a way around fat-clogged arteries in order to keep blood flowing to the heart. This is done by taking a segment of a blood vessel, usually from the leg, and grafting it into the chest, where it is used to create a detour around the obstruction. For patients with blockages in the left main coronary artery, the heart's principal conduit, a bypass offers the best hope of prolonging life. The procedure is also the treatment of choice for those with crippling pain due to several clogged coronary arteries...
...institute's study does not challenge these applications of surgery. Instead, it focuses on whether or not bypass operations extend the life of patients with less severe heart disease. Some of those selected for the study were suffering from mild to moderate angina, the viselike chest pains that signal a decreased supply of blood to the heart; others had a history of one or more heart attacks but did not have recurrent chest pains. The 780 participants, all under age 65, were randomly treated either with bypass surgery or with drugs, such as nitroglycerin and diuretics, that ease pain...
Nonetheless, bypass surgery did have some advantages. Says University of Ala bama Cardiologist William Rogers, a principal investigator in the study: "There are striking differences when one looks at the quality of life." Indeed, the bypass patients suffered fewer chest pains, had greater endurance on exercise tests and required less medication...
Given these advantages, why not always use the bypass? The answer lies in the nature of coronary heart disease. Arteriosclerosis, the buildup of fatty deposits in the arteries, continues to worsen no matter what the treatment (although patients who quit smoking, reduce fat in their diets and exercise regularly may improve their prognoses). So relentless is the disease that in 10% of bypass patients the newly grafted blood vessel becomes completely blocked within six months of surgery. For the more fortunate majority, blood will continue to flow through the bypass graft for years; however, other arteries may become clogged...