 | Joseph P. Galichia, MD is the founder and Medical Director of the Galichia Medical Group, PA. He is an internationally recognized pioneer in the field of interventional cardiology. In the 70's, Dr. Galichia studied in Zurich, Switzerland with the inventors of the balloon angioplasty technique for treating heart disease. As a result of his experience, he was able to bring this historic technique back to the United States where he was one of the first physicians to perform coronary angioplasty here. A noted medical spokesman, he appears on a weekly Newstalk segment on KWCH Channel 12 and has a weekly syndicated radio talk show on KNSS 1330 AM every Saturday live from 11:00 am to noon. Dr. Galichia may be contacted by sending an e-mail to service@galichia.com |
Health & Medicine
1969-12-31 18:00:00
Will I need another bypass?
: Is it true that a bypass patient can generally expect to need another bypass operation about every 10 years?
ANSWER: In order to understand the bypass surgery we should think of it as a treatment for the blocked arteries and not a cure. In the 1960's we learned that we can take veins from the leg and use as bypasses from the aorta to narrowed heart arteries successfully. This operation was first done by Dr. Favaloro and by the 1970's was becoming frequently performed procedure with excellent surgical outcomes. In those early days we felt patients may by fortunate to live only few years and we were not even sure that a repeat bypass procedure could be done. Many patients were told that operation might last five years but to expect little more. We discovered early on that many patients lived far beyond without complications and also that if new blockages occurred or the bypasses failed we could safely repeat a bypass operation. Investigations also demonstrated that the need for repeat bypass surgery became greater after five years, and that this risk extended throughout the patients' life. However, we also began aggressively treating patients for risk factors including smoking cessation, cholesterol reduction, weight loss, exercise, and blood pressure control. Furthermore, annual check-ups including a stress test helped to identify those patients at greater risk for recurrent heart attacks and other coronary events. A major breakthrough occurred in the early 1980's when the cardiologists began to use balloon angioplasty as a method of preserving bypass grafts and treating new blockages that occurred in the heart arteries. This enabled us to avoid the second bypass operation in a great number of patients. Technology has advanced rapidly in this area and we now have medicated stents, which are highly successful in salvaging old bypasses and treating new blockages in the native arteries. Also, we now are seeing patients who have lived 20 to 30 years following their first bypass procedure with hardly any complications along the way. Thankfully, our advise to patients in the 1960's and 1970's that their life expectancy would be short and that their options beyond the first bypass operation did not exist was false. More and more patients are avoiding bypass operations because of the simplicity and safety of balloon and stent procedures. For some patients, however, bypass surgery is the only reasonable option and maybe the only bypass procedure they will ever need.
