Statistics from the Centers for Disease Control and Prevention indicate that coronary artery bypass graft surgery was performed 395,000 times in 2010. This surgery is also known as a CABG or “cabbage”, or sometimes just referred to as open heart surgery. In this surgery, healthy blood vessels from some other part of the body are used to bypass one or more clogged arteries, which improves blood flow to the heart.
This surgery also aims to decrease chest pain or angina, improve shortness of breath, improve heart function, and reduce the incidence of death due to heart disease. However, there is a lot of disagreement in the medical community over the effectiveness of bypass compared to less invasive methods of treatment. Many studies have failed to support the overall value of the procedure. Some critics have labeled it a money maker for the medical industry.
According to Florida interventional cardiologist Dr. Chauncey Crandall,
Chauncey Crandall, M.D., heart bypass surgery should be considered a treatment of last resort. He recommends that if a patient’s condition is stable enough to allow for the extra time, a second opinion should always be sought.
About 15% of bypass surgeries fail within the first 3 months, and odds are high that the bypass will fail eventually. Sometimes the surgery must be repeated. Many doctors consider it palliative care rather than a cure. Bypass surgery also carries many risks, including the risk for blood clots, stroke, infection, and neurological damage when a heart-lung machine is used. Females tend to have poorer outcomes in general. Plus, the risks are higher for all those over age 70.
That being said, however, Dr. Crandall does believe that bypass surgery may be the treatment of choice for 3 groups of people:
1. Those with blockages of 75% or more in at least 3 coronary vessels, together with reduced function of the heart’s left ventricle.
2. Those with critical left main coronary artery disease of greater than 75%.
3. Diabetics with coronary artery disease affecting 3 vessels, even when less severe than 75%.
So if a bypass isn’t necessarily the treatment of choice, what are other options for patients with significant heart disease? Dr. Crandall recommends starting with the least invasive treatment possible, including medication and lifestyle changes, such as a plant-based diet, exercise, and stress reduction.
Interventional cardiologists also sometimes use procedures less risky than bypass, such as balloon angioplasty and stent insertion. The surgeon places a balloon in the blocked artery and inserts a hollow wire mesh tube to keep the artery open once the balloon has been removed.
In summary, heart bypass is a serious operation that should be thoughtfully considered, with all the risks and potential benefits explained to patients.
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