ANN ARBOR, Mich. - Millions of people with clogged arteries now have a new tool to help them decide, with their doctors, if bypass surgery will help them live longer and better, or if they face too many potential complications and should opt for another approach.
A set of comprehensive guidelines for physicians - based on a review of over 750 studies of coronary artery bypass and its alternatives - is being published in the October issue of the Journal of the American College of Cardiology. It was prepared by a committee of scientists, co-chaired by Kim Eagle, M.D., interim chief, division of cardiology in the University of Michigan Health System.
The report is the first update of the standard-setting American College of Cardiology-American Heart Association guidelines in eight years. It charts the rapid evolution of bypass surgery techniques, and competing medical and surgical techniques like angioplasty.
Most significantly, the guidelines divide heart patients into categories that predict how well bypass will work for them based on their heart condition, age and other factors.
"We used the most current knowledge about bypass to give doctors and patients a way to evaluate all the possible risks and benefits together," says Eagle. "We even address newer procedures, such as minimally invasive bypass, for which we urge caution in the face of uncertainty over success rates and complications."
The guidelines also present the best ways to prevent problems such as infection, heart rhythm problems and stroke, and suggest which medications and lifestyle changes bypass patients need. Finally, the authors call for more research on bypass in older people, minorities and diabetics - patient groups that have been underrepresented in past studies.
Bypass surgery restores blood flow to the heart by transplanting a patient's own
veins or arteries to go around one or more blocked arteries. Since its debut in
the 1960s, it has been performed millions of t
Contact: Kara Gavin
University of Michigan Health System