Unnecessary Heart Surgeries Don’t Address the Real Problem
According to two recent studies, one in the U.S. and one in Canada, the massive increase in cardiac “intervention surgery” in recent years in both countries has flooded new millions of dollars into the bank accounts of hospitals and physicians but has not reduced the heart attack rate in either country.
Most coronary artery bypass surgeries and artery-opening procedures performed today are intended to restore blood flow to the heart in order to prevent future heart attacks. However, both studies indicate performing such operations for this purpose reflects an outmoded understanding of heart disease. Data known for more than a decade shows that a constriction in the coronary artery is not where a future heart attack will occur. The vast majority of heart attacks occur when plaque breaks off and a clot forms in a different area, abruptly interrupting blood flow to the heart.
“If a person is having a heart attack, and that person has an artery-opening procedure while having the heart attack, there is good evidence that this will reduce the risk of dying of that heart attack,” said David Waters, MD, in an interview with the Center for Medical Consumers. Dr. Waters, who was not involved in either study, is chief of cardiology at San Francisco General Hospital and professor of medicine at University of California, San Francisco. He said data clearly shows that opening a narrowed artery has no effect on future heart attacks, and further stated, “We can assume that these procedures are not influencing the heart attack rate, and some may be unnecessary.”
According to cardiologist Thomas Graboys, MD, “The interventional cardiologists know about [the new understanding of how heart attacks happen], but they ignore it.” Dr. Graboys, professor of medicine at Harvard Medical School and president of the Lown Foundation, told the Center for Medical Consumers that there is a strong financial incentive to look for constricted arteries and open them. “Economics drive the train,” he said. “The starting salary of an interventional cardiologist is $300,000-400,000 a year, and for one that has been in practice three years, it is $500,000 to $600,000.”
Dr. Waters also sees money as the driving force: “If you have chest pain and the cardiologist you see does coronary angiography and that pays for his kids to go to college — well, are you more likely to wind up with that procedure? Get a second opinion from a cardiologist who is not in the same building, the same group, or the same hospital as the first cardiologist.” Dr. Waters also suggests we choose carefully the type of cardiologist for a second opinion. There are regular cardiologists who prescribe drugs; interventional cardiologists who do cardiac catheterizations, artery-opening procedures and stenting; and cardiovascular surgeons who perform coronary bypass surgery. The opinion received will likely mirror that doctor’s area of expertise.