BETTER BYPASS SURGERY
Coronary bypass surgery is the most common open-heart procedure performed in the U.S. But as many as one in 20 bypass operations are unsuccessful. Now, new technology is allowing doctors to fix those bypasses while the patient is still in the OR.
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Ernest Frost
Coronary Bypass Patient
"It felt like that, that pressure, as if someone had a knuckle pressing into a muscle."
Ernest Frost is describing the feeling he'd get between his shoulder blades if he walked no faster than this.
Ernest Frost
"It would build up so that it was very uncomfortable."
Ernest had heart trouble. He needed a bypass operation. In most cases, surgeons don't know if the surgery is a success until after the procedure. But doctors used a new technology -- called spy -- to track ernest's surgery.
Marc Pelletier, MD
Cardiothoracic Surgeon
El Camino Hospital
Mountain View
California, CA
"It gives us a roadmap of the arteries on the heart and of the bypass that we've done."
A green dye is injected in the heart and attaches to proteins in the blood. It emits light when stimulated by a laser. Watch as the dye lights up blood flowing through the arteries -- showing Doctor Pelletier that the bypass is working.
Marc Pelletier, MD
"I'd rather take an extra 15, 20 minutes during the operation to do something if it's going to mean an extra several years for the patient."
The system allows him to fix a bypass while patients are still on the table ... Sparing them from another surgery or angioplasty.
For Ernest, it meant peace of mind from the moment he woke up.
Ernest Frost
"They were commenting that it went well, so I felt very good."
He's now walking with no pain and without any worry about the success of his surgery.
Doctors can use an angiogram in the OR to track progress, but it exposes everyone to X-rays and can be toxic to patients. Spy poses none of these risks. Right now, there are about 40 centers using the technology.
BACKGROUND: SPY is a new technology that cardiothoracic surgeons can use in the operating room for patients undergoing coronary bypass surgery. SPY is a non-toxic, safe dye that's injected into the body. A laser activates the dye, which gives doctors a road map of the arteries of the heart and of the bypasses that they've done.
ADVANTAGE: Cardiologist Marc Pelletier, M.D., a cardiothoracic surgeon at El Camino Hospital in Mountain View, Calif., says, "When we do our bypasses, we want to have something in the operating room that tells us if we've done a good job or not. To use a traditional angiogram is very difficult. You have to wear lead; it's a toxic dye; it can be harmful to the kidneys -- especially when it's done at the time of surgery." With SPY, Dr. Pelletier says, "Before we finish the operation, if there's anything that we need to change, we can do it right there and then and not have to wait a week or two later, which is the last thing you want to do. You can make those changes in the operating room." He explains about one in 20 of all the bypasses that doctors perform have a technical problem. Having a system such as SPY helps doctors pinpoint any difficulties and ensure a level of quality control before they leave the operating room. Otherwise, the bypass patient may have angina or a blocked artery at a later point. Between 5 percent and 10 percent of patients eventually need a re-operation, and that percentage is in part due to technical issues during the first operation. "We're just trying to eliminate some of those technical issues; we're trying to make the operation a little bit better for our patients and a little bit safer," Dr. Pelletier says.
REVOLUTIONARY: Dr. Pelletier says SPY is very different from anything doctors have used before. "We've had Doppler, or ultrasound technology, to give us an idea of what we were doing in the operating room, but we've not had a technique that's been as easy to use and that gives us as good of a visual system of what we're doing," says Dr. Pelletier. "Now, we can see with our own eyes a picture of something that we're used to looking at. We look at angiograms all the time, but we can look at those pictures now in the operating room, and that's the big difference."
UNDER STUDY: There's a study underway to test the effectiveness of the technology in the operating room and determine how patient outcomes are affected.
FUTURE: Several centers across the United States are beginning to use the technology. Dr. Pelletier says, "I think you're going to see it being used more and more in the United States."
Carol Walovich
Stanford Hospitals & Clinics
300 Pasteur Dr.
Stanford, CA 94305
(800) 756-9000
www.stanfordhospital.com
Copyright © 2006 Ivanhoe Broadcast News, Inc.
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