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Question
Posted by: sm00thman | 2006/10/30

complications after bypass

I am curious to know how true is it that bypass surgeries involving insertion of stints are resulting in heart attacks and strokes because these new stints were designed to make blood flow easier, discontinuing the use of medication after surgery.
please reply via my e-mail address since I don't go into this room that often. thanh you.

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Our expert says:
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Dear Smoothman,

Unfortunately this forum does not allow for your email address to be displayed, so I can only reply to your question here.

Bypass surgery does not use stents. Stents are used by cardiologists to try to keep open arteries which have become narrowed or blocked by atheroma or clots. Once these stents have been inserted, the patient needs MORE, NOT LESS, medication, because the body tends to reject the foreign material of the stents. Part of the body’s rejection/inflammation mechanism results in the formation of a clot within the stent. Unfortunately ,this is the very thing the stent was supposed to prevent. Once the artery and stent are totally blocked by the clot, a heart attack occurs.

Very often, after stents have failed, the patient is referred to a surgeon for bypass surgery, as this is more successful than the stent. In bypass surgery, veins from the patients legs or other donor sites are used to create new vessels bypassing the blocked arteries. As this the patient's own tissue, there is no rejection of the grafts. When more than one artery is affected, surgery is usually more effective than stents, and patients are better off having a bypass right from the start. However patients are often persuaded to have stents inserted because they can go home on the same day of the procedure. Unfortunately, we do see many “failed stents” on our operating table.

Stents have improved in recent years, and do have a place in certain conditions, where they can be of great value to the patient. But they are not the total answer to coronary artery disease, and do have a known significant failure rate.

HeartDoc

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