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Dr. Michael Ozner: 6 Cardiac Procedures You May Not Need

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Most patients assume when their cardiologist recommends surgical intervention for a partially blocked artery, there's no alternative. Likewise, many heart patients agree to certain diagnostic tests believing the doctor wouldn't prescribe them if there was a better way to get information about their heart's health.

In both cases, heart patients should know that certain heart surgeries and diagnostic tests may be harmful to their health. If your doctor recommends any of the six cardiac procedures below, get a second opinion, and tell him or her you are looking for a safer and equally effective alternative.

Bypass surgery. Three major studies performed in the late 1970s and early 1980s -- the VA Cooperative Study, the NIH's Coronary Artery Surgery Study, and the European Coronary Artery Surgery Study -- all clearly proved that for the majority of patients, bypass surgery is no more effective than conservative medical treatment. The bypass patients did not live significantly longer or have fewer heart attacks than those who did not undergo surgery. Recent studies agree with these results.

Angioplasty. Studies on angioplasty -- where a balloon-tipped catheter is inserted into the vessel and then inflated -- delivered even worse news. The famous 1999 AVERT Trial found that unless the patient was in the middle of a heart attack, opening a blocked coronary artery with a balloon catheter resulted in a worse outcome compared to management through medication.

Stents. This is a flexible, expandable wire mesh tube threaded into a vessel at the site of the blockage, and then expanded to hold the vessel open. Several clinical studies, most notably the OAT and Courage trials, found stents did not provide any benefit beyond that afforded by medical therapy alone. In fact, stents proved detrimental, increasing the occurrence of repeat heart attacks in the patients studied.

64-Slice CAT Scan. Cardiac CAT scans produce an astounding amount of radiation exposure for the patient, often the equivalent of up to 750 chest X-rays -- or more radiation than experienced by Japanese survivors of Nagasaki.

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These are the cardiac procedures which are often recommended by doctor. I am sure every 5 cardiac patients out of 10 must have performed angioplasty or stent placements. If the medication therapy can better manage these conditions, why are doctor recommending these costly procedures, which are not helping patients much in comparison to the medication management.


March 19, 2010 - 12:50pm
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