PreventDisease.com - First Nonsurgical Coronary Artery Bypass Performed



		First Nonsurgical Coronary Artery Bypass Performed NEW YORK (Reuters Health) - A 53-year-old man from Germany has become the first person to successfully undergo a new nonsurgical coronary artery bypass procedure. The procedure is called percutaneous in situ coronary venous arterialization (PICVA), and it involves using an ultrasound-guided catheter system to advance a needle through an artery wall and into an adjacent vein. The technique essentially redirects blood around a blockage in an artery by creating a channel into a nearby vein. ``This milestone marks the first coronary artery bypass performed with a catheter,'' Dr. Stephen N. Oesterle of Massachusetts General Hospital in Boston, said in a statement released by the American Heart Association (AHA). Oesterle, with other cardiologists from the US, Japan and Germany, describes the technique in the May 29th issue of Circulation: Journal of the American Heart Association. The technique may offer a quicker recovery time to patients than traditional bypass surgery. In traditional bypass surgery, the chest is opened up and a blood vessel that has been harvested from elsewhere in the body (usually the upper thigh) is grafted onto the heart. The new procedure was performed in November 1999 without complications. The patient has been free of heart disease-related chest pain for 12 months. Before the procedure, the patient had severe chest pain due to total blockage of the coronary artery. He was not a candidate for traditional bypass surgery or balloon angioplasty. Dr. Timothy Gardner, from the Hospital of the University of Pennsylvania, in Philadelphia, called the technique ``ingenious.'' But he did caution, in a telephone interview with Reuters Health, that the report describes short-term success in only one patient whose PICVA treatment was used in only one blocked artery. ``The vast majority of coronary artery patients who require angioplasty or bypass surgery need to have multiple blockages opened or bypassed,'' he pointed out. ``This new and very innovative technique must be proven safe and effective in many patients, especially those with more common patterns of coronary artery obstructions, before it is suggested that it will replace conventional angioplasty or bypass surgery,'' Gardner noted. Further studies need to determine the durability of PICVA and the risk of ``late heart circulation problems, such as too much blood flow into the coronary veins,'' he added. Dr. David Faxon, president-elect of the AHA, said that the procedure may be particularly useful in the increasingly large group of patients with chronically blocked vessels, ``but it won't be a solution for everyone.'' SOURCE: Circulation 2001;103:2539-2543. Reference Source 89 For more information on how to prevent other diseases, use PreventDisease.com's "Quick Prevention Resources".