After more than three decades of doing bypasses, which is major surgery after all, and before allowing virtually every hospital to set up shop to do it, you would think that there must be plenty of data to prove that this works. But that is not the case at all.
Three major studies, performed in the late 1970s and early 1980s, clearly proved that for the majority of patients, bypass surgery is no more effective than is medical treatment. These three studies were the Veterans Administration Cooperative Study (The VA Study), Coronary Artery Surgery Study (CASS) and European Coronary Artery Surgery Study (EuroCASS).
These studies began in 1977, when the VA study compared those who underwent bypass surgery with the medically treated group. The unexpected results showed that, with the exception of a small subset of patients, bypass surgery did not lower the death rate or prevent heart attacks. But, instead of taking serious note of these findings and beginning to question the procedure, the cardiology community as a whole criticized the study, believing the findings were somehow wrong, and that the opposite must be true. So the National Institutes of Health, our nation's official health agency, launched the CASS study. Like the VA study, the CASS study found that the majority of patients who underwent bypass surgery did not live significantly longer or have fewer heart attacks. The EuroCASS study found similar results.
If you are tempted to dismiss these studies, bear in mind that they all showed:
• These were well-designed studies that appeared in major medical journals.
• The cardiac medications available then were much less effective than today's medications.
• These studies were done in the 1970s, but the results are not outdated. These patients have been tracked and the subject of follow-up studies that have been performed over the past two decades. These follow-up studies show the same results -- bypass surgery does not prolong life or prevent heart attacks in the majority of patients.
Pitting Angioplasty Against Medical Treatment Head-to-Head
One of the trials most hotly contested by angioplasty proponents was published in 2000.