2007-05-23 / Health

Bypass surgery must often be repeated
By PAUL G. DONOHUE, M.D.

DEAR DR. DONOHUE: In 1995 I underwent quadruple heart bypass surgery. Now, 11 years later, an angiogram was taken and I was told that the grafts are not functioning well. A vein from my left leg was used for the grafts. As a result, a second bypass appears to be imminent. Is this a common occurrence? - I.C.

ANSWER: Heart artery grafts are an amazing medical triumph. They save lives. They prevent heart attacks. They bring blood to a blood-starved heart. However, they don't cure the underlying processes that clog blood vessels. Those processes are atherosclerosis - artery hardening - and artery blockage with cholesterol, fat and other material.

Diet, exercise, weight loss, and cholesterol and blood pressure control are things over which people have control and which can keep arteries free of obstructing buildup. Genes, however, are something we cannot control. And their influence on artery hardening goes on. They also influence buildup in grafts.

In about 10 years after bypass surgery, plaque - the obstruct- ing buildup on artery walls - greatly affects the flow of blood through many grafts. The degree to which it obstructs blood flow depends on how much people have done on their own to prevent plaque formation and how much influence their genes have on plaque buildup. It also depends on the kind of grafts used. Artery grafts resist plaque buildup better than vein grafts, but artery grafts are not always possible.

You are not unique. Repeat bypass surgery is relatively common.

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DEAR DR. DONOHUE: I have lived in the Great Lakes area all my life, and for most of my life I have had asthma. I am now retired, and people tell me I wouldn't have any trouble with asthma if I moved to the Southwest. My family and friends are here, and I don't want to pull up stakes and move. But I would if I thought it would help my asthma. Would it? - J.D.

ANSWER: Don't move until you visit there for a length of time. Some asthmatics find the dry and relatively pollen-free air of the Southwest beneficial. Not all do, and not all Southwest locales are free of air pollution and pollen. You have to see for yourself.

The asthma booklet presents this illness and its treatment in detail. Readers can obtain a copy by writing: Dr. Donohue - No. 602W, Box 536475, Orlando, FL32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6.75 Canada with the recipient's printed name and address. Please allow four weeks for delivery.

(c) 2007 North America Synd., Inc.

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