Four Surgeries to Avoid
Health Report
Why you should think twice before going under the knife
PHOTOGRAPH BY FREDRIK BRODEN BY KAREN CHENEY
A
Stents are tiny
mesh tubes that
surgeons use to
prop open arter-
ies carrying blood
to the heart. If a
patient is having a
heart attack, a stent
can be a lifesaver. But for heart disease
patients with stable angina—chest
pain brought on by exertion or stress—
a stent is not better at preventing a
heart attack or prolonging survival
than lifestyle changes such as exercis-
ing and taking statins to lower choles-
terol, according to a landmark 2007
Department of Veterans Affairs study.
Despite stents’ ineffectiveness,
close to 500,000 are implanted each
year for stable chest pain, says Sanjay
Kaul, M.D., a cardiologist at Cedars-Sinai Heart Institute in Los Angeles.
Surgeons frequently insert the stents
during heart-catheterization procedures to evaluate patients’ blood
vessels, says Lee Lucas, Ph.D., an epidemiologist at Maine Medical Center
Research Institute, who argues that
the catheterization should be done
first as a diagnostic test, and stenting
done later, if necessary. “This should
be a two-stage procedure, but patients
never get to leave the cath lab to think
about it,” says Lucas.
ALTERNATIVES TO SURGERY If your
doctor orders a heart catheterization,
ask that he or she wait to perform
any treatment such as stenting in
a separate procedure. Even before
submitting to a heart cath, make sure
you’ve explored other alternatives.
Have you had a stress test? Do you
adhere to a strict diet, exercise, or take
Stents
for
Stable Angina
NY SURGERY IS DANGEROUS. THE BODY CONSIDERS AN
operation a serious insult, and even some minor procedures
come with major risks, such as bleeding, blood clots, infec-
tions, and damage to other organs. So it’s essential to know
if surgery is necessary—or beneficial. The following four
operations are overperformed for a variety of reasons: Some are moneymakers
for hospitals and doctors, others are expedient, and still others seem to work,
at least in the short term. But evidence shows that all have questionable long-
term outcomes for treating certain conditions, and some may even cause
harm. Here’s what to do if your doctor recommends one of them.
