Features May 2008 Issue

Surviving Multi-Vessel Heart Disease: Which Procedure is Best for You?

Both stenting and bypass grafting can be effective, but the nature of your diseaseand your overall health are deciding factors.

In many cases of multi-vessel coronary artery disease (CAD), the decision to use stents or perform a coronary artery bypass graft (CABG) is clear: a patient with bad lung disease or another serious medical condition may be too sick and vulnerable to undergo surgery, or the nature of the patientís CAD may be too advanced or complicated to treat with stents. But when doctors and patients have the option to go with either stenting or CABG, a new set of criteria must be considered, including up-front risks, potential to relieve chest pain, long-term health, and the likelihood of needing subsequent procedures. "If the choice can be stents or bypass, the data donít show a real difference in mortality," says Deepak Bhatt, MD, associate director of Cleveland Clinicís Cardiovascular Coordinating Center.

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