A tiny ‘corset’ that fits over veins could save thousands of patients from repeat heart bypass surgery. The revolutionary mesh sleeve protects grafted vessels being damaged by the body’s blood pressure – the main reason bypass operations fail in more than half of cases after ten years.
Heart disease happens when the blood supply to the organ becomes restricted when the arteries that supply it become clogged. This can lead to parts of the heart muscle becoming starved of oxygen, triggering chest pains – a condition known as angina – or a potentially fatal heart attack.
The problem can be tackled by heart-bypass surgery, which involves doctors removing healthy veins from the legs and transplanting them into the heart. Acting as replacement arteries, these grafted veins divert the blood flow around the clogged arteries and improve oxygen supply.
The operation, known as coronary artery bypass grafting surgery (CABG) can be a life-saver.
It is one of the most commonly performed procedures by the NHS, with 26,000 carried out each year. However, the failure rate for CABG is high, with many patients requiring repeat surgery often after less than ten years.
But now results from the world’s first trial of the corset show that five years after treatment, transplanted veins fitted with the plastic and metal device are almost as good as new.
Heart surgeon David Taggart, who led the research at the John Radcliffe Hospital in Oxford, said the pioneering treatment is ‘almost certainly the future’ for CABG.
He said: ‘We’ve made the surgery and recovery from bypass surgery really safe over the years but patients can still die or need repeat surgery because the grafted veins become blocked.
‘People have been trying to find a solution for decades. We think this could finally be the answer.’
One of the first to benefit from the procedure is former film industry manager John O’Toole, who had heart-bypass surgery five years ago. The 83-year-old from Greenford, Middlesex, had been diagnosed with heart disease in 2011 after feeling ‘out of puff’ a few times while walking up hill.
In 2013, an angiogram – an X-ray of his blood vessels – revealed that two of his heart arteries were completely blocked and two were 60 per cent obstructed.
‘The consultant told me I could drop down dead any minute,’ said Mr O’Toole. ‘She said it was like driving a car without petrol.’
Doctors fitted the metal and plastic mesh tube around one grafted vein when he had a quadruple bypass at the Royal Brompton Hospital in London. Recovery took about seven weeks.
Mr O’Toole said: ‘Since having the op, the doctors have looked at the vein that has corset around it four times over the past five years, and it’s still as good as new.
‘It’s reassuring to know I’m not going to run out of petrol any time soon.’
The revolutionary mesh sleeve protects grafted vessels being damaged by the body’s blood pressure – the main reason bypass operations fail in more than half of cases after ten years
Leg veins are used in CABG operations because they are plentiful and their removal does not compromise circulation.
But they are not designed to cope when blood from the heart pumps through them at high pressure as their walls are thinner than those of arteries.
At one year after surgery, an estimated 15 per cent of grafted veins have significant damage. The figure at five years is 40 per cent and, after a decade, 60 per cent.
The veins bulge or enlarge – but the new corset stops the veins from failing by preventing this bulging.
A total of 60 patients from heart surgery units countrywide, including Papworth, the Royal Brompton and Harefield and Southampton, have taken part in trials of the vein corset.
Each CABG operation costs the NHS £12,000 and the addition of an Israeli-developed corset costs only an extra £500.
Tony De Souza, surgeon at the Royal Brompton and Harefield NHS Trust, said the corset idea was ‘a brilliant solution. The operation can be truly life-saving for someone who may have every artery in their heart almost totally blocked’.