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Cardiac Bypass, Angioplasty and Stenting by Jeffrey Dach MD

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Coronary angiogram cardiac cath cardiology LAD left anterior descending
Cardiac Bypass, Angioplasty and Stenting by Jeffrey Dach MD

No Reduction in Mortality or Heart Attacks  

The following thirty nine medical studies compare invasive treatment with conservative treatment of coronary artery disease.  Invasive treatment with bypass surgery, stent or angioplasty is compared  with conservative treatment with drugs.   These Thirty Nine Studies show that invasive treatment fails to reduce mortality or heart attacks, when compared to conservative medical treatment with drugs.

Brain Damage from Cardiac Bypass

Three studies in 1000 patients found that 50% of patients having bypass surgery have brain damage with permanent loss of memory and mental function.

Economic Benefits Make it Popular

Invasive treatment with bypass and angioplasty may not be the best treatment, yet is more likely to be offered because of the economic benefits.

Cardiac Bypass Operation with Surgeon holding Instruments
Limited Cases see Reduced Mortality with Cardiac Bypass

Coronary Bypass has been found to prolong life in the limited number of cases who have both left main coronary disease and reduced ejection fraction.  However, if Left Ventricular function is normal (i.e. normal ejection fraction), then bypass does not affect over all mortality compared to medical treatment.
Left Image Cardiac Bypass courtesy of Wikimedia Commons

Recent Stent Era Trials

Acute MI is a special case

Stenting after thrombolysis for acute Myocardial Infarction found to reduce mortality:

Schiller's study in Germany showed that immediate stenting after using clot busting drugs gave better mortality results when compared to delayed stenting. Three more recent stent-era trials have shown favorable reduction in mortality with stenting.  However, this has not been consistently demonstrated.

However for multivessel coronary disease, no advantage over medical treatment seen with stenting.

Dr Richard Shemin writes in Circulation in 2008,"Survival advantages of stent therapy for coronary artery disease over medical therapy have not been a consistent result in clinical trials."

Compared to CABG, no advantage for stenting

A five year trial published in 2005 comparing stenting to CABG for multivessel disease shows no difference in mortality.

Medical Treatment for Heart Disease

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Jeffrey Dach MD is a physician and author of three books, Natural Medicine 101, and Bioidentical Hormones 101, and Heart Book all available on Amazon, or as a free e-book on his web sites. Dr. Dach is founder and chief medical officer of (more...)

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