|
Coronary Heart Disease Treatment
Medical Technology
Saving & Improving Lives
Courtesy of AdvaMed
One million Americans die from coronary heart disease each year-that's about 2,600 every day; one person every 33 seconds. That also works out to be the equivalent of some 10 jumbo jet crashes each day. It's America's number one killer. It takes more lives than cancer-in fact, more than cancer, accidents, and the next five leading causes of death in the United States combined. And those most susceptible to cardiovascular disease happen to be in the middle and older years of their lives.
Medical Technologies for Treating Coronary Heart Disease:
The good news is that medical technology is helping defeat cardiovascular disease. Diagnostic imaging systems arm physicians with detailed roadmaps of blocked arteries. Video-cam surgical tools permit heart repairs with only minor incisions. High-tech pacing devices return normal rhythms to failing hearts. And researchers stand at the frontier of bold advances-from lab-grown arteries to corrections for defective genes to implantable diagnostic systems.
The good news for the U.S. economy is that advanced medical technology plays a significant role in reducing disability and death from coronary heart disease. In 2001, the estimated direct and indirect costs of coronary heart disease is $100.8 billion. Leading health economists say that the drop in mortality from coronary heart disease yields economic value of $300 billion annually. Moreover, technological advances are improving provider productivity and thus reducing health care costs.
Health Care and Economic Costs of Coronary Heart Disease:
The total estimated direct and indirect costs of coronary heart disease in the United States during 2001 are $100.8 billion. 1
- The estimated direct costs of coronary heart disease in 2001 are $53.4 billion. That includes hospital, nursing, and physician care, as well as drugs, medical technologies, and supplies.
- The estimated indirect costs of coronary heart disease in 2001 are $47.4 billion. That includes the costs of lost productivity due to mortality and morbidity.
- CHD is the primary cause of permanent disability among U.S. workers, constituting some 19% of Social Security disabilities.
- Medicare spent $10.8 billion for treating CHD in 1997.
1American Heart Association, 2001 Heart and Stroke Statistical Update, Dallas, Texas: American Heart Association, 2000.
Methods for Treating CHD: One of the most common methods of treating CHD has been an invasive procedure known as coronary artery bypass graphing or CABG, where surgeons reroute the blood around the blockages by attaching blood vessels from the chest or leg.
It is considered major surgery; the breast bone must be split, the heart stopped, and the patient's blood must be routed through a heart-lung machine. In some cases, serious complications can arise from the procedure, including stroke, atrial fibrillation, blood clots, kidney failure, lung failure, memory loss, and even death (3% mortality rate)2.
The procedure has a significant cost, $27,000 and lasts between two and four hours. Patients typically are required to stay in the hospital 5-6 days, but Medicare patients average about nine days. Patients must spend 2-3 weeks recovering3 and are able to return to work 4-6 weeks after surgery. However, sometimes it can take as long as 6-12 weeks4.
New and Emerging Technologies for Treating CHD: Several technologies treat CHD without the extensive surgery required for CABG.
- Angioplasty: Physicians use a catheter to open the obstruction in a coronary artery, thus avoiding surgery and long recuperation. The procedure requires an incision in the leg, and no heart-lung machine is needed. The location of the catheter is shown by x-ray images on a monitor.
- Angioplasty can produce minor complications. It costs significantly less than CABG -- $12,0005. The procedure typically lasts less than two hours, often slightly more than 30 minutes. Patients only need to remain in the hospital for one day, and the recovery time is roughly a week.
- Angioplasty with Stent: Physicians use a catheter to open the obstruction, then insert a small latticed, metal scaffold called a coronary stent. These devices improve blood flow, keep the artery open, and relieve pain.
- This procedure too costs considerably less than CABG -- $15,0006. Patients normally spend about 90 minutes getting the device. They are typically out of the hospital in one day and back to work in a week. Angioplasties with stents are highly successful in keeping arteries open and reducing need for additional procedures.
- Angioplasty with Brachytherapy: Physicians use a tiny coil on a catheter to deliver radiation to the artery in an effort to prevent it from closing in the future.
- Complications from the procedure are minor; however, radiation exposure may increase cancer-risk. The cost of angioplasty with brachytherapy is also significantly less than traditional CABG -- $17,000. It is successful in keeping arteries unclogged
- Minimally Invasive CABG: Rather than using open-chest surgery, physicians operate through small openings, or ports, between the ribs. Incisions are four inches wide. Micro surgical instruments, some only 1/8 inch wide, perfect fine finger movements in removing and sewing arteries. Digital cameras on the tips of the endoscopes allow a full field of vision. Some incisions can be closed with an adhesive strip. A heart-lung machine is not used for "beating-heart" procedures7.
- This innovative form of CABG produces minimal risk of stroke; usually little bleeding; as well as less pain, infection, and scarring. Hospital stays after the procedure are only 3-4 days, compared to 5-6 days with traditional CABG. Patients normally can return to work in 10-14 days8
About Coronary Heart Disease: Coronary heart disease (CHD) is the single largest killer of Americans. The condition results from narrowing of the arteries that supply blood to the heart. This can produce chest pain, heart attacks, and death.
Population (US): CHD killed 460,000 people in 1998, according to the American Heart Association9. It is responsible for one in every five deaths.
- Every 29 seconds, an American will have a heart attack. Every minute, an American will die from a heart attack.
- In 1998, 50.8% of deaths from coronary heart disease were males; 49.2% were females.
- 1.1 million Americans will have a heart attack this year; 450,000 of those will be recurrent attacks, while 650,000 will be first-time attacks.
- 12.4 million Americans who are alive today have experienced heart attacks, chest pain (angina pectoris), or both.
2"What Are the Surgical Treatments for Angina and Coronary Artery Disease?" WebMd.
3Heart Surgery Forum, www.hsforum.com
4"Minimally Invasive Cardiac Surgery," by William R. Mayfield, M.C., Peachtree Cardiovascular and Thoracic Surgeons, P.A.; www.hsforum.com
5"Acute and Long-term Cost Implications of Coronary Stenting," by Peterson, et.al., Journal of the American College of Cardiology, Vol. 33, No. 6, 1999.
6"Acute and Long-term Cost Implications of Coronary Stenting," by Peterson, et.al., Journal of the American College of Cardiology, Vol. 33, No. 6, 1999.
7"Moving Toward Better Bypass Surgery," by Denise Mann, WebMD Medical News
8"Minimally Invasive Cardiac Surgery," by William R. Mayfield, M.C., Peachtree Cardiovascular and Thoracic Surgeons, P.A.; www.hsforum.com
9American Heart Association, 2001 Heart and Stroke Statistical Update.
|
