Bypass, Angioplasty Similar in Survival
10 Years After Heart Procedures, Survival Rates Differ Little
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Bypass Surgery, Angioplasty: Pros and Cons
Each procedure has downsides and benefits, the researchers found. Bypass
surgery, Hlatky says, "is longer lasting, more durable, and gives more
The downsides? "There is a higher risk of stroke during the procedure,
and a longer recovery time."
Angioplasty is a ''simpler procedure and the recovery is faster," he
says. Downsides: "It is very likely you will need a second procedure within
six months. And there is not as much chest pain [angina] relief."
Strokes during the interventions occurred in 1.2% of bypass surgery patients
and 0.6% of angioplasty patients. While 79% of angioplasty patients got angina
relief at five years, 84% of surgery patients did.
The new analysis is "very complete," says Kim A. Eagle, MD, director
of the Cardiovascular Center and Albion Walter Hewlett Professor of Internal
Medicine at the University of Michigan, Ann Arbor.
The study shows, he says, that if either procedure is considered appropriate
for an individual patient, the decision can rest on patient attitudes and
While he finds some patients prefer to undergo bypass surgery, especially
with its lower need to repeat, others want to avoid surgery and prefer
"If you are uncertain, get a second opinion," he says. "Ask hard
questions." Such as: "What would be the downside of angioplasty in my
situation? Any factors I have that might make you want to think about bypass
instead of angioplasty? Is there a compelling reason to do anything? Is medical
therapy equal to intervention [for me] in terms of preventing heart attack or
Another expert, Curtis Hunter, MD, director of cardiothoracic surgery at
Santa Monica-UCLA Medical Center & Orthopaedic Hospital in Santa Monica,
Calif., says it is important for patients to realize the studies cover the
least sick of heart disease patients, those for whom either procedure is
"The two procedures are only shown to be equal in a very small subset
and the healthiest portion of the population [with heart disease]," he