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Bypass Surgery, Stents Seem to Bring Same Level of Relief
Date:3/17/2011

y assigned 1,800 heart patients to undergo either bypass surgery or a stent procedure. These patients had either three-vessel or left main coronary artery disease. The study authors followed up six and 12 months later to see how the patients were doing.

At a year, 76 percent of bypass patients said they were free of chest pain, also known as angina; 72 percent of stent patients said they were, according to the report.

"I'm not sure that this is earthshaking," said Garratt. "It was a fully predictable finding, considering what we already knew."

There are other factors for patients to think about before getting an operation. Stent patients face a higher need for repeat operations than bypass patients, Cohen noted. "If a patient has a strong aversion to coming back, a bypass operation is going to be more durable. It will last longer and keep them out of the hospital longer."

And patients with the most complex cases will fare better -- both in terms of quality of life and lifespan -- after a bypass, Cohen said.

In general, though, "if you're one of the unlucky few that need more than medicine to take care of your heart disease, both surgery and angioplasty promise to give you excellent results," Garratt said.

They won't necessarily help you live longer, however. Neither procedure has been shown to boost lifespan by a meaningful amount, Garratt said, except for heart attack patients. "What they add," he said, "is quality of life."

The findings are published in the March 17 issue of the New England Journal of Medicine.

More information

For more about heart disease, try the U.S. National Library of Medicine.

SOURCES: David J. Cohen, M.D., director, cardiovascular research, Saint Luke's Mid America Heart Institute, Kansas City, Mo.; Kirk N. Garratt, M.D., M.Sc., associate director, division of card
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