UT Health doctors push for multiple arterial coronary bypass grafting as a life-saving treatment

February 3, 2016 | News, Medicine and Life Sciences, UTMC
By Brandi Barhite



The University of Toledo Medical Center continues to offer cutting-edge treatment for those suffering from coronary artery disease.

Cardiovascular disease, including atherosclerotic coronary artery disease, remains a significant public health challenge and is the No. 1 killer in the developed world.

Schwann

Schwann

Coronary artery bypass surgery and stenting are the two principal treatment options for coronary artery disease.

Dr. Thomas A. Schwann, professor of thoracic and cardiovascular surgery, in collaboration with investigators from Mount Sinai Medical Center in New York and the American University of Beirut, published a paper in the Journal of the American College of Cardiology on the effectiveness of each of these treatment options in a study involving more than 8,000 patients.

The investigators determined that a new form of coronary artery bypass surgery, using multiple arteries, as opposed to the standard coronary artery bypass surgery, in which only one artery and additional vein grafts are used, is the best treatment for patients with the most complex coronary artery disease. Using multiple arteries in coronary surgery resulted in a statistically significant increase in patient survival compared to stents that release medication.

The paper concluded that multi-arterial coronary artery bypass surgery is the optimal treatment for the most complex patients and “should be enthusiastically adopted by practicing cardiac surgeons and members of a multidisciplinary heart team as they strive to implement best evidence-based therapy.”

UT Health cardiac surgeons are on the forefront of multi-arterial coronary artery bypass surgery and have published extensively on the subject with the same consistent message that compared to traditional surgery, multi-arterial surgery saves lives. With the current publication, they have further extended the value of multi-arterial coronary surgery showing improved outcomes compared to coronary stents.

“Traditional single arterial coronary artery bypass surgery is the ‘Chevy’ of cardiac surgery, while multi-arterial coronary artery bypass surgery is the ‘Porsche’ of cardiac surgery,” Schwann said. “By using multi-arterial coronary artery bypass surgery we extend patients’ lives for up to 15 years post-operatively.”

Despite this compelling data, Schwann said only 10 percent of all coronary artery disease patients in the United States receive more than one arterial graft during their operations, while 70 percent to 80 percent of UTMC patients receive multi-arterial coronary artery bypass surgery.

“Cardiac surgeons and cardiologist work collaboratively at UTMC as part of an integrated heart team to choose the best treatment option for our patients,” Schwann said.

“We are working with our professional societies to influence our colleagues nationally to adopt a similar strategy. One artery is good, but using two or more is clearly a superior treatment strategy.”

He said future investigations are needed to delve deeper into patients who benefit most from multi-arterial coronary artery bypass graft.

“In conjunction with the Society of Thoracic Surgeons, we are trying to secure grant funding to study this issue on a nationwide basis to fundamentally change the surgical treatment of coronary artery disease,” Schwann said.