A study that was published in the last couple of years on the subject of Surgical Treatment for Ischemic Heart Failure, dubbed the STICH trial, has found that you might not need bypass surgery… yet. But, even so, the study’s ultimate conclusion is that bypass surgery cannot be avoided or put off for too long.
The researchers discovered that there were benefits in treating people at risk of heart attacks or heart failure with just medical therapy, to begin with. At least, until came the time where the mortal risk was too great. At that point, the researchers found that a combination of both bypass surgery and medication for treatment would be best as it can increase the patient’s overall life expectancy.
About the STICH Trial
The STICH study enrolled 2,112 patients who were potentially in-line for Coronary Artery Bypass Grafting (CABG Surgery) as a result of both Coronary Artery Disease (CAD) and Congestive Heart Failure (CHF.)
More specifically, it studied patients who were suffering from heart failure or unnatural heart movements as a result of narrowed or blocked-off arteries in their hearts.
If this applies to you, then you should know that the researchers found that while CABG surgery and medical therapy increased the risk of mortal complications after the first 30 days of surgery, they saw significant improvement in the long-term mortality (up to 10 full years) of patients who take medical therapy alone.
In the end, only 14 patients, after CABG surgery and medical therapy, needed to be treated with CABG surgery once more in over 10 years. This showed great improvement over previous findings. Like, for example, this study that was reported on by the Washington Post, which found that of 1,324 patients operated on between a 12 year period, only 74% had survived 10 years.
The survival rate had been pretty stable since then, and we didn’t see much improvement until at least the early 2000s when both CABG surgery and medical therapy was implemented.
Who Actually Needs Bypass Surgery?
Now, one of the key subjects of discussion over the STICH trials is that it focused on patients with both CAD and CHF. These patients were already in-line for bypass surgery, as the risk of mortal complications would be too great if they were left without it.
However, that doesn’t mean that everyone needs bypass surgery. According to the American College of Cardiology, CABG surgery can be put off or avoided depending on the severity of your CAD. Primarily, by taking advantage of angioplasty with stents — which can help increase the productivity of narrowed arteries, or medical therapy and lifestyle changes.
At the end of the day, whether you need bypass surgery will depend on your own unique situation. Your doctor should be able to tell you what you can do in order to avoid surgery and whether it would be safe for you to avoid it at all!
For example, you may be advised to have bypass surgery if…
- The occlusion (blockage) of major heart arteries are causing CHF
- Your doctor determines that the occlusion cannot be treated with stents
- You need open-heart surgery to repair or replace a heart valve
- You have diabetes and two or more blocked arteries
- You are suffering from Ejection Fraction (poor heart movements)
Other factors that may play a deciding role in whether you can put off or avoid bypass surgery may include your age, your general health, and how much your chest pain (angina) is affecting you in your daily life.
Alternatives to CABG Surgery
If you want to read an in-depth article on what you can do to avoid bypass surgery, then read this past article of ours that focuses on the Alternatives to CABG Surgery.
To summarize our findings there, there is no ultimate cure-all to those with Coronary Artery Disease. It presents itself as a life-long condition that must be constantly kept in check. There are alternative treatments like angioplasty or stenting — like we mentioned earlier. And, you can even put off the progression of CAD with medical therapy or major life changes. Both acts as a preventative measure that can stay the worst of the complications for some time.
However, at the end of the day, CABG surgery still presents the most appealing treatment for longer life expectancy prospects. So, if your doctor recommends CABG as the best treatment, then it is more likely than not to actually be the best choice for you.
If you’re still unsure even now, get a second opinion from another doctor who will be able to look objectively at your current situation and determine what the best treatment will be.
- “Surgical Treatment for Ischemic Heart Failure.” American College of Cardiology, 27 Feb. 2017, www.acc.org/latest-in-cardiology/clinical-trials/2014/07/30/12/15/stich.
- Blakemore, Erin. “Once Scary, Heart Bypass Surgery Has Become Common and Safer.” The Washington Post, WP Company, 25 Feb. 2018, www.washingtonpost.com/national/health-science/once-scary-heart-bypass-surgery-has-become-common-and-safer/2018/02/23/4b7459a4-157f-11e8-8b08-027a6ccb38eb_story.html.
- “Sections.” Global, www.cardiosmart.org/healthwise/av20/37/av2037.