Is Endoscope Really Harmful For Heart-Bypass Patients?

During heart bypass surgery or what is also known as coronary artery bypass surgery, heart surgeons have to remove a blood vessel from the heart disease patient’s chest or leg and attach one end to the aorta and the other end to the coronary artery below the point where it is clogged. By doing so, the blood can then flow through the new vessel to the heart muscle the way it should. Aorta refers to the large artery coming out of the heart.

Data showed that the leg veins of about 70 percent of the bypass patients are being removed by endoscopes. The main reason is that it produces much less scarring and infection to the leg than the traditional method known as ‘open harvesting’, a technique that remove vein by directly cutting along a stretch of the leg.

Endoscopes have widely been used for various procedures and were utilized for vein harvesting for 13 years. Endoscopes are little cameras, which can be inserted, sometimes with surgical instruments, via a small incision in the skin.

Meant to be less invasive and gentler, the endoscopic technique of removing leg veins appeared to damage the veins and lead to heart attack, and in fact, it would cause patients 52 percent more likely to die within 3 years.

The study of 3,000 patients by researchers from Duke University Medical Centre in Durham, North Carolina reported on July 15, 2009 in the New England Journal of Medicine that veins removed by the endoscopic technique were significantly more likely to become clogged within a year or so.

Measurements at the end of 12 months and 18 months showed that 47 percent of the patients had at least 1 of their bypass grafts fail, while only 38 percent for those using older method of removing veins. Most patients had 2 or 3 grafts.

At the end of 3 years after the heart surgery, patients whose leg vein was removed using endoscopes had 38 percent higher risk of death or non-fatal heart attack. For death rate alone, the risk was 52 percent higher: 128 of the 1,753 patients with endoscopic technique died, as compared with only 71 died of the 1,247 patients who had open harvesting.

As stipulated in the report, though ‘open harvesting’ is no doubt more invasive and associated with more wound complications, it might be less traumatic to the vein and could result in a better conduit. After listening to the pros and cons of both techniques, most patients still prefer to adopt endoscopic technique, as patients rather choose the short-term benefits over the possible the long-term risks.

Fruit Juice May Be Superior Than Fruit To Prevent Heart Disease

Fruit and vegetables should form part of everyday’s diet if one wishes to prevent heart disease and maintain a healthy body. Yet, most of the health experts would advise us not to take fruit juice because it may cause a person to gain weight.

However, a recent study by French researchers from the Universite Montpellier reported in May 2008 that grapes, apples and their juices could prevent atherosclerosis being developed in hamsters eating a high-fat diet, high-cholesterol diet.

The term atherosclerosis refers to buildup of fatty plaque deposits in the arteries that can lead to heart attacks or stroke.

The study found that fruit juices had a more powerful anti-atherosclerotic effect than the fruit itself. This is probably the first time that processing fruits can have a major impact on its health benefits.

In the study, hamsters were fed with grapes, grape juice, apples, apple juices or water, along with a diet designed to promote atherosclerosis. The aim is to investigate how juice might influence the content of phenolic compounds, which are powerful antioxidants contained in fruits. Meanwhile, a control group of animals ate normal chow.

The hamsters, which were fed with fruits, had the amount equivalent to 3 apples or 3 bunches of grapes daily for a human, while the amount of juice given to another group of hamsters was equivalent to 4 glasses daily for a person weighing 70 kilos.

The researchers noted that apples and grapes had roughly the same phenol content but the purple grape juice had 2.5 times more phenols than apple juice.

When comparing with hamsters given water, those consumed fruit or fruit juice had lower cholesterol levels, less oxidative stress, and less fat accumulation in their aorta (the main vessel supplying oxygenated blood to the body). In terms of health effects, purple grape fruit rank high, followed by purple grapes, apple juices and apples.

According to the researchers, while the amounts of phenols contained in a food have a direct effect on its antioxidant properties, other antioxidant compounds in the fruits such as Vitamin C, carotenoids could also contribute to their effects. Such findings do provide encouragement that fruit and fruit juice may have significant clinical and public health relevance.