Should You Have Angioplasty or Bypass Surgery?

According to an article in the Los Angeles Times, 5,000 or more people die each year because their doctors elected to perform angioplasty instead of open heart surgeries. This is mostly because patients and cardiologists prefer angioplasty because it is easier and the patients recover and return to work faster. But a new study from the European Association for Cardiothoracic Surgery on more than 1800 patients from Europe and America shows that three years after the procedure, those who were given stents were 28 percent more likely to suffer a major event, such as a heart attack or stroke. There were also 46 percent more likely to require a repeat procedure and 22 percent more likely to die.

According to Robert Guyton, the chief of cardiothoracic surgery at Emory University School of Medicine. "Stenting is a little bit easier on you, and the return to work is quicker. But the benefits of surgery are more enduring and tend to emerge as time goes by." "Anytime that you compare angioplasty and surgery, the longer you go, the better surgery looks." Said Michael J. Mack, co-author of the study.

Bypass surgery was the original procedure for blocked arteries, but in recent years, many cardiologists have used balloon angioplasty and stents instead. Instead of a hospital stay of five or six days and several weeks off work, an angioplasty patient can leave the hospital the next day and return to work a couple of days later. From personal experience, I know the bypass patient has many months of rehab to allow the sternum and chest muscles to regain their strength. It can take up to two years for the chest to fully recover.

The study found that for patients with a single blocked artery, the angioplasty worked as well as bypass surgery. But for patients with blockages in the left main artery and one of the three other arteries or with long blockages or very curvy arteries, the bypass surgery was shown to provide significantly better outcomes. The latter group represents about half of the more than 1.3 million patients undergoing angioplasty in the United States every year. Currently, about 450,000 have bypass surgeries, according to the National Center for Health Studies.

After reading this article, I am glad I had bypass surgery, although the doctors never really gave me a choice. Not only did I have three highly-blocked arteries, I also had long blockages in curvy arteries - which would have made stents difficult to impossible to insert. It has been nearly three years since I had a triple bypass surgery and I am feeling fine. You can read more about my bypass surgery experience here.

REFERENCES:

Personal experience

http://articles.latimes.com/2010/sep/12/science/la-sci-bypass-angioplasty-20100912