Over the past 50 years, the treatment of heart conditions has benefitted from many dramatic developments. Sometimes, however, patients are confused by the different options and medical opinions. Should you go for a stent or a bypass or just medication? Should you see a cardiac surgeon or an interventional cardiologist? There are no pat answers. This is why experts now believe that a team approach is essential to help you select the best course of action.
It hasn’t always been this way…
Bypass vs. Stents
Inherited abnormalities, diseased heart valves and blockages of the coronary arteries have been studied for over half a century and creative ways were found to diagnose and fix many problems. Along the way, there were useful improvements in protecting heart muscle, making anesthesia safer, helping the failing heart and providing high-tech care in specialized intensive care units.
An epidemic of coronary disease made coronary bypass surgery the most frequently performed and best-studied operation in human history with impressive success rates. The use of catheters from the groin, to inflate tiny balloons to dilate coronary blockages and insert metal mesh stents to prop open artery walls was also a major development in treating the heart.
Cardiac Surgeons vs. Interventional Cardiologists
For a time, heart surgeons who advocated the proven benefits of coronary bypass surgery and interventional cardiologists who offered the evolving stent techniques seemed to be in adversarial positions. Hospital meetings and national conferences were enlivened by heated debates. Complicating matters, some techniques showed promise, but later turned out to be ineffective or even harmful. Since that time, careful and objective scientific studies have defined more accurately the exact circumstances that are best treated by surgery or stents or even medications.
What Approach is Right for You?
At Beth Israel Medical Center, every heart patient consults with a team of both surgeons and cardiologists. Guided by the standards of professional societies like the American Heart Association and the American College of Cardiology, the heart team recommends a carefully considered and personalized course of action based on the patient’s specific disease and general condition, as well as the latest scientific evidence.
Darryl M. Hoffman, MD, is an attending physician at Beth Israel Medical Center.