I was wondering why they use stents so much when they only last about two years. Open heart surgery is realitvly safe now and can be done by not even going on the balloon pump for a few vessles on some people. I know there is no doubt a higher risk involved with open heart but, over all woudn't it be easier to go in and fix the problem for several years instead of a limitied solution? Is this a money maker for cardiologist's?

Our open hearts all go on the bypass so the grafts can be done. They were trying a different approach a few years back, but I have not seen it lately. I don't think it work well, but I'm not sure. The bypass is not a balloon pump. A balloon pump is put in to help increase cardiac output. This used in patients sometimes after open heart surgery if needed. We use it in bad Myocardial infarctions (heart attacks). It lessens the work of the heart. In answering your question if you can have a stent or a angioplasty done or both rather that being cut open I would go for it. Some people have to have open heart because they can't fix them by angioplasty/stent. No I don't think it is a money maker for cardiolgist, because they typically have had a cardiac cath done first before they decide they can't help the patient. When you have open heart surgery your recovery time it a lot different than just a cath. Some patients do well and some don't. A lot depend on their over all health. I hope this helped.
A ICU nurse

Yes it did and I did mean to say bi pass don't know why I said balloon pump. Thanks so much for your thoughts on this. Sam

You ask a complex question, for which there really aren't black and white answers. The placing of stents or other measures to treat coronary narrowing is done in many circumstances, and you correctly note the long term outcome may not be as good as with surgery. However, many agree that if a person has only a single narrowing, stenting makes more sense than surgery; also, in the situation of acute infarction (being in the middle of a heart attack), when often it is proper to go right to the cath lab to try to open the artery, if the anatomy is right a stent should be placed: it can prevent permanent heart damage. Going to surgery under those circumstances can be extra dangerous, and take too long to open restore flow to prevent damage. Many things are being investigated to prevent or delay restenosis, with success. You are correct that techniques exist to perform bypass of a vessel without going on the heart-lung machine, and they are becoming safer and more successful all the time (they are frequently done in my hospital). This probably reduces some of the danger of coronary surgery, but certainly not all. As with many choices in medical care, it can be a tough call: chosing something which may have a less long-lasting effect but which involves less risk, cost, recovery time, etc; vs a possibly more durable result but with more possible short-term danger. Make the choice a hundred times, there will be cases on either side wherein you wish you chose the other. Generally, the situation for stenting is with a single vessel problem (except for some highly critical vessels such as the left main coronary artery, occlusion of which can lead to acute death), and for surgery is when multiple vessels need fixing.

Thanks so much Sid for your answer. I always get alot out of your posts. Our hospital still does a vessel or two without going on bypass. They usually do very well. Maybe the people with stents then would do well getting a cath done every year to check the stent out? Thanks