I decided to write about natural bypass as an alternative to coronary bypass surgery and angioplasty because of the recent controversy over another alternative called chelation therapy.
A recent study published in the Journal of the American Medical Association has created quite a brouhaha in medical circles. That’s because it validated, rather than refuted, the use of controversial chelation therapy in patients who’ve experienced a heart attack.
Chelation therapy involves the intravenous administration of chemicals that remove calcium from patients’ arteries and blood vessel walls. This occurs over the course of 40 weeks – the first 30 of which require weekly visits of 3-hour treatments.
This is considered both arduous and inconvenient for patients. Yet up to 100,000 of these treatments are estimated to occur in America every year, mostly in alternative medicine centers.
Is It Quackery If It Works?
There’s been plenty of reporting in the mass media and healthcare blogosphere about the storm of controversy created by this study, dubbed the TACT study. The responses from cardiologists on the cardiology website theheart.org, however, have been remarkably muted. This is notable considering that their two fundamental premises about a treatment they have long considered quackery – that it’s both ineffective and dangerous – were disproven.
The adverse effects of chelation therapy were relatively minor. And those completing the treatment regimen had an average 18% lower rate of subsequent cardiovascular events that included both heart attacks and strokes than those receiving the placebo treatments. For diabetics, there was a 39% improvement in avoided cardiovascular events.
The controversy over this 10-year, government-funded study isn’t likely to die down any time soon. And few in mainstream medicine are suggesting this single study means chelation therapy is ready for prime time as an alternative to heart bypass surgery or angioplasty.
But there’s another alternative to these high-risk procedures, called a natural bypass, that has already been shown to be both safe and effective. And it costs a fraction of these income-producing stalwarts of conventional medicine.
Before considering this natural bypass alternative, however, it’s worth providing a little context about the relative dangers of these highly invasive options for treating stable angina patients.
Treatment Risks Under-appreciated
PCI angiography has lower mortality rates than bypass surgery. But it still poses substantial risk – including a substantial risk of heart attack (myocardial infarction). Here’s what a review by Mayo Clinic physicians in The New England Journal of Medicine had to say on this subject:
“Approximately 1.5 million patients undergo (PCI) in the U.S. every year…5 to 30% of these patients (75,000 t0 450,000) have evidence of a…myocardial infarction…
“At the higher estimate, the incidence of these events is similar to the annual rate of major spontaneous myocardial infarction (emphases added).”
This means that stent procedures that have grown dramatically over the past decade – and are promoted as lower risk alternatives to bypass surgery – may cause as many heart attacks as otherwise occur on their own.
That’s a pretty big deal that few outside the medical profession – and many within it – have no clue about.
Better, Safer & Cheaper
Here’s an excerpt from an article in the American Heart Association journal Circulation describing the natural bypass process:
“In humans, very small, hairlike vessels (capillaries) are often the only interconnections between the coronary arteries and their service areas. Sometimes, however, larger vessels interconnect the supplied areas. These vessels are called ‘collateral vessels’ or ‘natural bypasses.’ Only these collaterals, not the capillary network, are capable of delivering an adequate amount of blood to the heart muscle.”
This natural bypass process of building a stronger collateral network to better supply the heart with blood is the basis for a non-invasive treatment for angina and heart failure that’s FDA-approved and covered by Medicare. It’s called Enhanced External Counter Pulsation (EECP). This low-tech natural bypass procedure passively exercises the heart muscle to strengthen the vascular system and reduce chronic inflammation that contributes to plaque buildup.
But the natural bypass alternative is also inconvenient. It can take up to 35 1-hour sessions of inflatable cuffs, similar to blood pressure cuffs, wrapped around your legs that force blood back to the heart. This ultimately reduces the heart’s workload.
This natural bypass basically mimics the effects of exercise in improving circulation and enhancing alternate pathways for blood to reach the heart.
Not only is a natural bypass safe and painless, but patients report greater relaxation, energy, sexual capacity, tolerance for exercise, and reduced angina pain.
A natural bypass may be less “convenient” than PCI or surgery – if you consider having your chest cracked open convenient – but the lower risk and broader benefits are compelling. It may not be appropriate for severely advanced disease, however. Reviewing the appropriateness of a natural bypass with your doctor could help you avoid a high-risk invasive procedure.
More people with chronic angina should consider a non-invasive natural bypass to retrain the body to revascularize itself by creating new blood vessels that “bypass” any clogged arteries without interventional procedures – hence its appropriate nickname of “natural bypass”.
Don’t Be a Victim of Overly Aggressive Treatments
Low-tech procedures like a natural bypass that mobilize the body’s innate self-healing abilities are better value and safety propositions for many patients with stable angina who might otherwise be prescribed angioplasty or bypass surgery.
This is especially so when almost 1-in–3 patients undergoing angioplasty don’t have significantly blocked arteries (meaning they probably don’t need the procedure).
At ⅓ the cost of angioplasty and ⅙ the cost of bypass surgery – as well as the avoidance of other costs like a pre-treatment invasive angiogram (not needed with EECP) – the financial benefit of taking this “road less travelled” makes compelling financial sense as well.
Here are a few online resources to further evaluate this non-invasive treatment:
eecp.com – Locate EECP sites near you;
globalcardiocareinc.com – Video description of procedure; and
For further motivation to do so, consider these words from Dr. Mauro Moscucci of the University of Miami Miller School of Medicine regarding PCI reperfusion interventions:
“In an environment in which…physicians are being compensated on the basis of…productivity (more procedures), it remains to be determined whether personal financial gain might play a role in…performing procedures shown to be of no benefit.”
In other words, many of these heart attack survivors are being ripped off by greedy doctors performing useless PCI stent procedures that could, in fact, cause them another heart attack (see Our Healthcare Sucks for more examples of unethical medical behaviors).
A natural bypass could help you avoid such victimization.
Stable Disease Warrants
The point here isn’t that PCI angiography and bypass surgery are never necessary. There will obviously be circumstances where they’re unavoidable – cardiac emergencies, unstable angina, and other high-risk cardiac situations (when they’re often underused in older patients).
But the evidence fails to support their routine elective use for stable cardiac disease as currently employed. One study found that some hospitals performed inappropriate stent insertions more than half the time.
Anyone considering either procedure for chronic chest pain should certainly get a second opinion before consenting and raise these reservations with their doctors. You might also ask about your options for a natural bypass alternative.
The risk, after all, is all on you and your family.
 Cardiologists continue to invest in a variety of diagnostic imaging modalities, but according to a new survey, CT scanners lead the way. Imaging Economics. March 2009.
 Source: www.heartfixer.com.
 Medical Reversal, Clinical trial, and “Late” Open Artery Hypotheses in Acute Myocardial Infarction. Arch Intern Med.,Published Online July 7, 21011.
 Appropriateness of Percutaneous Coronary Intervention. JAMA:2011;306(1):53-61.