KTVT CBS 11 Health Alert
Dr. Lewis Pincus
Taping Script, Wed. May 30, 2001

Non-Surgical Bypass Surgery

Anchor: “Inoperable” is a medical term no physician ever wants to say, and certainly no patient ever wants to hear it. Some hope for inoperable coronary artery disease patients was announced this week by the American Heart Association. Here with the information is our medical expert, Dr. Lewis Pincus.

Doctor: In November of 1999 a team of heart surgeons from Massachusetts General Hospital traveled to Germany to perform the first coronary artery bypass surgery ever done without an incision, using only needles, catheters, and guide wires. The patient, a 53 yr. old German man, had blockages in his coronary arteries (the blood vessels supplying the heart muscle with blood) so extensive that all traditional options were not available.

Currently patients with coronary artery disease are best managed with invasive, or surgical options. Once the diagnosis of a blockage is suspected, the real diagnosis is usually made with a heart catheterization. Balloon angioplasty or bypass surgery are the standard treatment options we have for patients who qualify. But each year there are about 100,000 patients where nothing works, where some combination of medications and limiting physical activity is all physicians have to offer.

Such was not the case with the German gentleman, whose coronary disease was so extensive that neither bypass surgery nor angioplasty a possibility. Researchers, thinking the problem through from “outside the box”, wondered, since very frequently in the body wherever there is an artery there will also be a vein traveling with it, would it be possible to re-route blood flow from an open coronary vein into a blocked coronary artery?

So, a standard heart catheterization was done, and the research team was indeed able to push a needle through the wall of a coronary artery, through and into a companion coronary vein. Through a series of guide wires, balloons and kinks, blood flow in the vein was reversed so that it traveled back into the previously clogged artery, thus sending critically needed blood flow into a starving section of heart muscle. Amazing.

Now, is this technique available? No. Has it worked every time? No. Is the possibility for the future so exciting that studies to identify long term results, including safety, re-blockage, and survival will be starting soon? Absolutely. Our German friend is alive, well, and active, one year later. In this particular situation we don’t need thousands of patients studies laboriously for many years to get people excited. It just took one, so let’s see what happens. Looks like a fascinating new use of technology.

For CBS Health Alert, this is Dr. Lew Pincus, and back to you.
 

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