Common Heart-Bypass Surgery Technique Said to Increase Risk of Heart Attack

If you are among the nearly half-million Americans who will undergo a heart bypass surgery this year, you might want to ask your doctor what method of leg vein harvesting will be used in your procedure.

A new study finds that the less-invasive surgical method used in 70 percent of all heart bypass surgeries, which is designed to decrease pain, scars, and post-operation complications, actually increases the risks of dying or suffering from a heart attack within three years.

Researchers from Duke University Medical Center said using smaller “porthole” incisions in the leg to harvest the vein used in bypass surgery may be less painful, produce less scaring, and require shorter hospital stays than the old “groin to toe” incision method, but it also increases the risk of heart attack.

They said their new study should serve as a “wake-up call” to surgeons and patients who tend to prefer less-invasive surgical techniques that sometimes, traditional methods are best.

Thousands of Bypass Surgeries Studied

In the study, researchers examined the records of more than 3,000 patients who had bypass surgery at about 100 sites across the United States. However, the drug-based study was not designed to evaluate the risks and benefits of leg artery harvest techniques, so the results should be read with some caution, they admit.

Still, the researchers said patients in the study who had the small incisions made to harvest their leg vein were significantly more likely to die, suffer a heart attack, or require another surgery to open a block artery within three years.

More than nine percent of people whose veins were removed with the small-incision method died or suffered a heart attack in the following three years, compared to less than eight percent of those who had the traditional big incision, the study found.

The study’s authors theorized that the reason is that the vein is damaged when it is pulled through the smaller incisions and does not hold up as well over time, according to an Associated Press report.

So the bottom line is: Making a larger, longer incision in the leg to remove the leg vein may produce an uglier scar and increase post-surgery pain and infection risks, but the transplanted vein comes out in much better shape in the long run, the study authors said.

‘Very Worrisome’ Findings

Dr. Timothy Gardner, a heart surgeon at Christiana Care Health Services in Wilmington, Del., and former American Heart Association president, called the findings that appeared in the July 15 issue of the New England Journal of Medicine “very worrisome.”

While researchers said more study is required to confirm the study results, Gardner said surgeons should handle veins more carefully during harvesting to reduce the risk of future heart attack or additional artery-opening procedures.

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