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April 1, 2011 > Voices InHealth: Decisions In Cardiac Care

Voices InHealth: Decisions In Cardiac Care

InHealth Channel Program Examines Treatment Options for Coronary Artery Disease

Coronary artery disease is the most common type of heart disease and the leading cause of death in the United States for both men and women, according to the National Institutes of Health. While the disease is common, there is no one treatment that is guaranteed to be effective for all cases. Treatment options are focused on opening up blocked arteries with the help of medications or surgical interventions.

In an upcoming InHealth Channel television program titled: "Voices InHealth: Decisions in Cardiac Care," two leading Washington Hospital heart specialists will discuss some of the treatment options available for coronary artery disease.

Stents Hold Arteries Open

"Coronary stents are mesh tubes that are inserted into a blocked artery," explains Ash Jain, M.D., an interventional cardiac specialist and co-medical director of Vascular Services at Washington Hospital. "Once in place, they expand, opening up the blockage."

During the television program, Jain talks about the use of stents and discusses some of the factors that lead to the decision to insert a stent. Over the years, he has been a principal investigator in a number of clinical trials to determine the effectiveness of stents.

"We first try angioplasty, which involves inserting a balloon to push open the blockage," Jain says. "If that doesn't work, we move to the stent. About 80 to 90 percent of the time, people end up needing a stent. With balloon angioplasty, the balloon is removed. But with the stent, the metal mesh remains in the artery to keep it propped open."

According to Jain, stent technology has improved dramatically over the years. Today stents are much smaller and more flexible than earlier versions. He said the real breakthrough was the advent of stents that are coated with medications that help to prevent the buildup of plaque.

"Stents coated with medication have significantly improved success rates," he says.

Surgery Bypasses Blockage

When the stent doesn't work, the next step is often coronary artery bypass grafting, according to Jon Cecil-Walkes, M.D., heart surgeon and Washington Hospital's medical director of Cardiothoracic Surgery. During the show, Walkes highlights some of the factors that lead to the decision to perform open heart surgery.

"By the time the patient comes to me, they have already tried stenting," says Walkes. "With bypass surgery, we create a path around the blockage for the blood to flow through."

During the InHealth show, Walkes describes how the surgery can be done either with the heart stopped, referred to as "on-pump" because a machine is used to pump the blood, or with the heart still beating, referred to as "off-pump."

"It used to be that all bypass surgeries were performed on-pump," he says. "But 90 percent of the procedures we are doing are off-pump. It's much better for the body to have the heart continue to beat naturally during surgery. We are seeing shorter hospital stays and less memory loss with the off-pump procedure."

When You Need Cardiac Care

For more information about Washington Hospital's Heart Program, including videos and a list of physicians, visit or call (800) 963-7070 for a physician referral. "Voices InHealth: Decisions In Cardiac Care" is currently airing on InHealth, a Washington Hospital Channel on Comcast 78. You can also watch this show and other current programs online at InHealth is available to Comcast subscribers in Newark, Union City and Fremont.

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