Not too long ago it seemed as if coronary artery bypass surgeries (CHAB) were pretty common. But a new study shows that there has been a noticeable decrease in the number of these operations. Unfortunately, it’s not that Americans are suddenly heart healthy. Heart disease and blocked coronary arteries are still on the rise. And more hospitals than ever offer open heart surgery. But less invasive procedures are now considered a better option and are performed more often.
In fact, one-third fewer coronary artery bypass graft (CABG) surgeries were performed in 2008 compared to 2001, while the rate of less invasive angioplasty procedures remained largely unchanged, according to a study published in the Journal of the American Medical Association.
In 2008, three out of four patients had angioplasties instead of CABG, compared with two out of three patients a decade ago. Even though it may seem as if this is progress, some medical experts, like Peter W. Groeneveld, MD, of the University of Pennsylvania School of Medicine, think that in some patients would have a better outcome if they had the more invasive CABG. Groeneveld and colleagues analyzed trends in heart surgery practices in 1,000 hospitals across the country from 2001 to 2008.
In addition, Groenveld sounds this alarm: since more hospitals are offering the CABG, but doing them less, it will be harder to maintain the volume that might be necessary to guarantee the best outcomes from surgeons who become better from doing a procedure repeatedly. About 100 surgeries a year as a minimum has been considered standard for a surgeon. Now a quarter of hospitals offering CABG don’t even do a total of 100 a year. In essence practice makes perfect – and surgeons just aren’t getting the practice.
Current treatment guidelines from the American Heart Association and the American College of Cardiology favor CABG over angioplasty for patients with the most severe disease: those with extreme narrowing of three major coronary arteries and those with narrowing of the left main artery if they are healthy enough for surgery.
When it’s a close decision, patients are more likely to go for the less invasive procedures. If you’re on the line for a heart procedure to open blocked arteries, make sure to ask your surgeon how many procedures he’s performed and which one is really best for your condition. A second opinion is always a good idea.
Robin Westen is ThirdAge’s medical reporter. Check for her daily updates.
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