Tuesday, September 27, 2011
Cardiac Surgeons Criticize the Decline in Bypass Rates
According to the SYNTAX trial reported in the New England Journal, there was a 15% reduction in the number of bypass procedures performed from 2001 to 2008. There was a lesser decrease in the number of stents placed. Their conclusion was that bypass was being underutilized, for some unknown reason. How about the possibility that far too many of these procedures have been done in this country for many years? The evidence shows that lifestyle changes as a primary treatment is often a better choice than surgery. We do many more cardiac surgeries for heart disease than any other country in the world. Further, there is an increased use of alternative medicine. The results of the TACT trial on chelation therapy is due out in early 2012. Hopefully, that will stimulate an even great drop in the use of cardiac surgery. See New England Journal of Medicine (click here, subscription needed). 2009;360:961-72.