Friday, October 02, 2009

Is Endoscope Really Harmful For Heart-Bypass Patients?

During heart bypass surgery or what is also known as coronary artery bypass surgery, heart surgeons have to remove a blood vessel from the heart disease patient’s chest or leg and attach one end to the aorta and the other end to the coronary artery below the point where it is clogged. By doing so, the blood can then flow through the new vessel to the heart muscle the way it should. Aorta refers to the large artery coming out of the heart.

Data showed that the leg veins of about 70 percent of the bypass patients are being removed by endoscopes. The main reason is that it produces much less scarring and infection to the leg than the traditional method known as ‘open harvesting’, a technique that remove vein by directly cutting along a stretch of the leg.

Endoscopes have widely been used for various procedures and were utilized for vein harvesting for 13 years. Endoscopes are little cameras, which can be inserted, sometimes with surgical instruments, via a small incision in the skin.

Meant to be less invasive and gentler, the endoscopic technique of removing leg veins appeared to damage the veins and lead to heart attack, and in fact, it would cause patients 52 percent more likely to die within 3 years.

The study of 3,000 patients by researchers from Duke University Medical Centre in Durham, North Carolina reported on July 15, 2009 in the New England Journal of Medicine that veins removed by the endoscopic technique were significantly more likely to become clogged within a year or so.

Measurements at the end of 12 months and 18 months showed that 47 percent of the patients had at least 1 of their bypass grafts fail, while only 38 percent for those using older method of removing veins. Most patients had 2 or 3 grafts.

At the end of 3 years after the heart surgery, patients whose leg vein was removed using endoscopes had 38 percent higher risk of death or non-fatal heart attack. For death rate alone, the risk was 52 percent higher: 128 of the 1,753 patients with endoscopic technique died, as compared with only 71 died of the 1,247 patients who had open harvesting.

As stipulated in the report, though ‘open harvesting’ is no doubt more invasive and associated with more wound complications, it might be less traumatic to the vein and could result in a better conduit. After listening to the pros and cons of both techniques, most patients still prefer to adopt endoscopic technique, as patients rather choose the short-term benefits over the possible the long-term risks.

3 comments:

  1. In the cases of heart attack and cardiac arrest, or any other heart shocks, time sets to be the most crucial factor for the survival of the patient. Sometimes, a little knowledge regarding the immediate actions to be taken may help your near and dear ones to survive in such incidents. The response a person takes to treat a victim decides the probability of his/her survival. Its been my personal experience fighting to survive against a heart attack. A quick reorganization of your bodily responses may increase your chances of survival. Because of having many heart problems, I was enrolled in a concierge Healthcare program from elite health. I was attacked by a severe heart attack in a party, luckily surrounded by many people. Some of the sudden changes in my body was recognized by me and anticipated immediately. I got a very severe chest pain which was almost unbearable for more than a minute. I got the suspicion that I might be having heart attack, and immediately called my physician on the phone, and explained my condition and its severity. Because of the immediate guidance, I was directed immediately to have an aspirin which I used to carry with me as prescribed by my physician. It was quite a frightening experience for me to face such a heart attack, but somehow I managed to be calm until 911 arrived. I was immediately taken to the nearest hospital, where already my physician were present and have got everything setup according to my medical history. And it was in some matter of seconds that everything was in control. A doctor, who already have the complete knowledge of the medical history and fitness of the person, extra ordinarily ameliorate your recovery process. Hence such a concierge level program from Elite health, helped me a save my life, like many others.

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  3. I think the risk is partially associated with the endoscopes quality. I know a good company whose products you can count on.

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