A bypass procedure that transforms veins into arteries without opening the chest cavity could one day offer treatment for patients with severe coronary artery disease who cannot undergo traditional bypass surgery or angioplasty, experts said.
A case study being published in Tuesday's Circulation, a journal of the American Heart Association, documents the first nonsurgical bypass using catheters to make the coronary vein a conduit for blood flow around the diseased coronary artery. The catheters are inserted in a leg and threaded into the coronary arteries.
Dr. Stephen Oesterle, director of invasive cardiology services at Massachusetts General Hospital, and his researchers successfully conducted the new procedure, called percutaneous in-situ coronary venous arterialization, or PICVA, in November 1999 in Germany.
The study patient, a 53-year-old German man, had severe chest pain from a heart artery blocked by atherosclerosis, a buildup of fatty deposits in vessel walls. He was not a candidate for bypass surgery or angioplasty because his artery was almost completely blocked, Oesterle said.
Now, more than a year after the procedure, the patient remains pain free, he said.
The new procedure is considered safer and less painful than traditional bypass surgery, which requires opening the patient's chest, temporarily stopping the heart and harvesting vessels from the leg or chest.
But Oesterle warns that the procedure would not necessarily be preferable to angioplasty or bypass surgery.
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