Coronary bypass rates drop
Fewer people have undergone heart surgery since 2001
By Nathan Seppa
Think of it as bypassing the bypass. U.S. heart patients have been less likely in the past decade to undergo surgery to install a substitute vessel around a clogged coronary artery, with many patients getting a less invasive alternative procedure.
Coronary bypass operations decreased by 38 percent per capita in U.S. adults between 2001 and 2008, researchers report in the May 4 Journal of the American Medical Association. Meanwhile, angioplasty procedures — in which a doctor threads a catheter to the heart to open a blockage using a balloon — have stayed nearly constant, with the per capita rate dipping only 4 percent over that time. These catheters nearly always deliver a coated mesh cylinder called a stent, which props open the vessel from the inside. The study’s authors calculated the rates by analyzing a national sample of more than 5,000 coronary fixes.
The new findings reflect changes in coronary care that have arisen since specially coated stents gained U.S. regulatory approval in 2003, says study coauthor Peter Groeneveld, an internist at the University of Pennsylvania School of Medicine and the Philadelphia Veterans Affairs Medical Center. Coatings have made stents less prone to clogging.
Stents have obvious advantages over surgery — a shorter hospital stay, less short-term risk of complications and lower cost. In the traditional bypass operation, doctors remove vessels from less-crucial parts of the body and graft them to the heart to shuttle blood around blocked coronary arteries.