How Would You Like Your Bypass?

Heart disease is the number one killer of Americans and is responsible for 30 percent of world wide deaths, per year. The American Heart Association and the World Health Organization will provide details if you visit their websites. Most heart disease is caused by what we do(eat, drink and smoke) or do not do (limit fat intake, add fruits, vegetables and fish and EXERCISE).

In our country about a quarter of a million people will have an operation every year to manage the clogged arteries that accompany heart disease. This is done by grafting arteries so that the clogged ones, the ones that are so occluded blood may eventually get stalled in them, are by passed altogether.

I learned today that the most popular way to have coronary artery bypass grafting surgery (CABG) is either on pump or off pump. In other words, one's heart and lungs are either kept operating by a machine or they are not. It is very confusing to read about and more so to explain, though the heart is stopped in the off pump method, blood is still circulated but it must be done so manually.

Many studies have been done to see which procedure is safer and or more effective. A very large and randomized clinical trial was recently reported on in the New England Journal of Medicine. In that study of over 2000 Veterans Affairs patients, the off pump surgery led to more adverse outcome in the following year. There were more heart attacks, repeat surgeries and deaths. The difference in these events for the two groups was only 3% but of course that would matter if it were you or your loved one.

The on pump one is then better in some cases. Of course, no one is willing to call this conclusive and the study population, mostly men and mostly younger ones (well why younger?! isn't heart disease for old people?) anyway, they do not represent the country by any means.

It took me a while to find research on which procedure costs more but I found at least one to say that the off pump procedure was LESS costly. So there you go. This would be a case where comparative research shows that the more expensive procedure is safer and better!

I have to tell you that in trying to educate myself a little bit on the whole grafting thing, I became even more convinced of never eating high fat foods again.