New Findings on Revascularization Procedures

Research reported at the American Heart Association's Scientific Forum on Quality of Care and Outcomes Research in Cardiovascular Disease and Stroke included new findings on revascularization procedures.

Whether or not to use a heart-lung machine during a coronary bypass procedure was the subject of research presented by Dale R. Levy, University Hospitals (Cleveland, OH, USA). Although there is increasing enthusiasm for sidestepping the traditional heart-lung machine, Levy's researchers wondered if that would be too risky for some patients. They analyzed data from 482 patients, 274 of whom were having surgery without the machine. Although patients having off-pump surgery tended to be sicker, they had less post-operation kidney failure and stroke, spent less time in intensive care, and were less likely to be readmitted after discharge. The researchers concluded that because traditional bypass surgery is not detrimental to most patients, off-pump surgery provides the greatest benefit for the sickest patients.

A study of heart attack patients treated with either balloon angioplasty or bypass surgery was presented by Jing Fang of the Albert Einstein College of Medicine (Bronx, NY, USA; www.aecom.yu.edu). Researchers found that these revascularization procedures nearly doubled from 1988 to 1997. Angioplasty increased by 120% and bypass surgery by 60%. During that same time, the in-hospital death rate dropped by 33%. The researchers also found that older patients, women, blacks, and those without private insurance were less likely to have the procedures and more likely to die in the hospital. Although blacks and whites had different rates of revascularization, they had similar death rates overall.





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Albert Einstein College of Medicine
University Hospitals