For years, we have been reporting the overuse of the coronary artery-opening procedure called angioplasty, aka percutaneous coronary intervention. About one million people in the U.S. undergo this procedure annually; despite the fact that well-designed clinical trials proved that many are in non-emergency situations and can be treated just as effectively with the multiple drug therapy. These are the same drugs, by the way, that most people will be told to take after they’ve had an angioplasty. The procedure, done in non-emergency situations, has a death rate of at least 0.63%.

Lown Cardiovascular Center, Brookline, Massachusetts is the place to go if you want a second opinion about the necessity of angioplasty or coronary bypass surgery. Long-time readers may recognize the name of cardiologist Thomas Graboys, MD, of the Lown Cardiovascular Center, who was frequently quoted in HealthFacts over the years, expressing concern that angioplasty had become a cash cow for many hospitals. In one memorable interview, he said that many symptomless people are scared into undergoing angioplasty after “failing” a stress test and told they are sitting on a “time bomb.” Such people, he said, could have been safely treated with daily aspirin and avoided the procedure.

Dr. Graboys, professor of medicine at Harvard Medical School, first came to our attention in 1992 when he co-authored a seminal study showing that angioplasty can be safely deferred in many people who have been told that the procedure is urgently needed. This and many other studies he co-authored over the years led him to recommend a second opinion when a cardiac catheterization is advised because this diagnostic procedure puts people on the proverbial conveyer belt to having an angioplasty or coronary bypass surgery. Sadly, Dr. Graboys is no longer with the Lown Cardiovascular Center. He was forced into premature retirement in 2006 due to Parkinson’s disease and dementia. He wrote a book about the experience called Life in the Balance.

Visit the Lown Cardiovascular Center Web site to see what a second opinion involves and to read the bios of the six cardiologists on the staff and no cardiovascular surgeons. Let us know if there’s a similar center in your area.

Maryann Napoli,Center for Medical Consumers(c)

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