Q: Why would former President Clinton needs stents placed in his heart if he had open heart surgery in 2004? Is this common?
A: Unfortunately, although coronary artery bypass grafting surgery effectively relieves angina and prolongs life in many patients, angina recurs in 5-10% of patients, primarily due to failure of one or more of the bypasses.
Bypasses are created using either veins from the leg or arteries from the arm or shoulder. Several studies have shown that 15-30% of vein bypasses begin to narrow 1 year after surgery and that nearly 50% of vein bypasses are completely closed at 10 years. When bypass narrowing and closure occur beyond 1 year after surgery, the cause is usually from fatty plaque build up and clot formation.
When this occurs, we usually have several possible options for treatment. One is to try to clear the diseased bypass itself with angioplasty and a stent. Another option is to try to perform angioplasty and stenting on the original blockage in the patient’s heart that the bypass was going to. This is what apparently was done in President Clinton’s case; one of his vein bypasses was completely closed and his physicians elected to perform a stent procedure to the heart’s artery that the closed bypass was connected to.
Other options for treatment include managing symptoms with medications, or, in extreme cases, repeat open-heart surgery.
The most important thing to remember is that surgery is not a cure for coronary artery disease. Although surgery is very effective in relieving symptoms and prolonging life, new plaque and blockages can continue to develop. A heart-healthy diet, exercise and routine follow-up with your cardiologist are essential.
This post is published by Sherman Health to provide general health information. It is not intended to provide personal medical advice, which should be obtained directly from your physician. For more information on heart health, click here to visit Sherman’s Heart and Vascular Center.