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HEART ATTACK OPTIONS: THE SURGICAL ARMOURY-CORONARY BYPASS SURGERY
The most important aspect of a heart attack recovery procedure, modern medical experts say, is to limit the amount of damage done to the heart muscle, which can never be repaired. Yet right at this critical moment, while the heart is struggling to recover from its trauma, established medical procedure more often than not performs heart surgery, thus creating more scar tissue and putting a highly compromised patient further at risk from what is a major operation.
In the last 25 years, the coronary artery bypass operation (officially known as CABG or CABS) has become one of the most prolific of surgical procedures. In America, something like a quarter of a million bypass operations are executed each year. In Britain the annual figure is moving towards 20 thousand, which is a lot of bypasses for a country that runs on a severely budgeted national health scheme, especially when the cost of each operation is between $30,000 to $45,000 each (figures are for the USA because they are easier to ascertain but Britain corresponds).
The operation involves:
sawing through the breastbone, and stopping the heart (before which the bloodstream has to be diverted to an artificial pump which takes over the respiration and circulation functions during the operation process)
selecting and cutting out a blood vessel – either a vein from the leg or an artery from the chest
grafting that blood vessel around (i.e. bypassing) the blockage or blockages in the coronary arteries
restarting the heart with an electric shock
As an emergency procedure following the trauma of a heart attack, this is a mighty load to inflict on a body struggling for life in any case, and as such would need to be totally justified as a life-saving enterprise. Yet there have been many studies to show this is not so, including the previously mentioned Veterans Administration Study, which detected no difference in the rate of survival between those who had bypass surgery and those who did not, ‘unless the patient suffered from an obstruction of the left main coronary artery’.
A duplicate study in 1978 by the US National Institute of Health confirmed these findings. Then in the 1980s further studies (the most recent being by the US National Heart Lung and Blood Institute) compared bypass surgery with non-surgical medical therapy and found that bypass surgery achieves no better results in preserving life than conventional drug therapy for the majority of people, severe cases as described in the introduction excepted.
Why is this operation still being done for all and sundry more than 15 years later?
A look at the statistics and reports which have been accumulating on both sides of the Atlantic, especially in the last 10 years indicate that conservatively speaking, 50-60 per cent of bypass operations are unnecessary and/or unhelpful to the condition for which they were done in the first place.
When all the statistical analysis shakes down on this comparatively recent operative procedure (about 30 years in America, less in the UK) it will be seen that far more than 60 per cent of all bypasses performed are not only unnecessary but also damaging to the health of those who have them.
Here are some salient reasons why:
an average of 5 per cent of all bypass operations result in death
over 30 per cent of bypass patients’ grafted arteries block within
the first five years, while 10-15 per cent fail in the first year. So, the operation has to be repeated
over 25 per cent of those having their chests split open experience terribly crippling complications. There are the complications of the leg grafts, causing swollen feet and varying degrees of pain and discomfort on walking, occasioning the need to wear a support bandage on the afflicted leg. Then there are the more difficult to pin down symptoms suggesting neurological damage, possibly, some experts say, due to tiny bubbles of oxygen or other tiny impurities getting into the brain during the time the circulation is on the machine, or other tiny impurities. These are estimated at around 20 per cent
If these figures seem too round, the reader is referred to the bibliography where literally dozens of research papers are listed in many books. The problem with getting exact statistics on bypass or any other surgical procedure is that factors like death rates during surgery vary from about 2-10 per cent depending on how good or bad the surgical unit is that performs the operations. But averages cannot lie, the overall figures are irrefutable, leading to the inevitable conclusions that:
bypass surgery is bad news (after one or two repeat bypasses the , patient is abandoned)
bypass surgery is bad for arteriosclerosis (evidence mounts that on the suture sites of the grafts arteriosclerosis is actually exacerbated. Furthermore, vein grafts were never built to carry blood under pressure and may fail. As one expert said, ‘Bypass surgery is a patchwork solution to a degenerative disease that affects the entire arterial system, not just one or two replaceable blood vessels.’)
It must be remembered that bypass surgery not only concerns itself with the coronary arteries, but with arteries in other key sites such as the carotid artery leading to the brain and the femoral/polipteal arteries leading to the legs.
In two groups of men whose carotid artery was more than 50 per cent occluded, half of which had bypass surgery and half did not, although there was reduced risk from getting strokes in the surgical group, there was no improvement in the death rate between the groups due to four
postoperative deaths and three strokes associated from arteriography (diagnostic technique) from the surgical group.
Furthermore, the main cause of death in both groups was not from a brain-associated stroke but from coronary heart disease!
Neither of the two groups taking part in the study had symptoms – which leads to the question: if a basic tenet of orthodox medicine is that it treats symptoms and that no treatment can be justified unless there are symptoms, why are thousands upon thousands of youngish people in their forties and early fifties (symptomless people who have been screened because of professional or insurance requirements) being given bypass surgery, or angioplasty? Could it be that they are ideal subjects to improve the otherwise grim survival statistics?
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