Is Heart Bypass Surgery Becoming a Common Procedure?

Is Heart Bypass Surgery Becoming a Common Procedure?

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QUESTION: It would seem from all the people who I know that have had it that
heart bypass surgery is becoming a common procedure. Is it an operation that
everyone with diseased heart arteries should have?
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ANSWER: I have a fairly direct answer to this question and it is a resounding
"No". When you have coronary artery disease, your heart's arteries are
obstructed, or clogged. This condition can be present in varying degrees of
severity, and in a portion of one or in all of the heart's arteries. When a
bypass is performed, the diseased artery is "bypassed" with a "new" artery,
usually an artificial graft or possibly one fashioned from a section of a
vein removed from the leg.
There are also other ways to treat coronary artery disease. Some are
medical therapies and there are other surgical procedures besides bypass. The
only way to know the exact nature of coronary artery disease and the best way
to treat it is by using a diagnostic procedure called "angiography". This
allows the doctor to take a type of x-ray picture that shows the actual state
of the arteries that carry blood to the heart, and discover if any of them are
partially or totally blocked. Everyone with chest pain does not necessarily
require this procedure, so your doctor will be evaluating your total situation
before he asks you to have one done.
However, once the procedure has been performed, a specific diagnosis can
be made about your condition which will determine whether surgery might be the
best course for you to take. Since bypass surgery was introduced in 1968, it
has been studied by many different researchers in many different settings.
Coronary artery disease is very complex, and we do not know all about it that
we need to know. However, the National Institutes of Health in 1985
recommended some guidelines to help physicians evaluate those circumstances
which will benefit most from bypass surgery. Among those diagnoses that
warrant bypass surgery are uncontrollable chest pain with severe heart artery
obstruction and greater than 50% obstruction of left main coronary artery.
One of the diagnoses that was listed as a debatable cause for bypass surgery
is the obstruction of all three of the main heart vessels, if the heart is
still functioning well, where medical treatment may offer satisfactory
results.
There is usually sufficient time before making a decision about heart
surgery for you to become well informed about your need for it, as well as the
risks and the chances for the outcome you are hoping for.