Newswise — MEDIA ALERT: Experts from the Methodist DeBakey Heart Center are available to discuss implications of a Food and Drug Administration panel that met this week to consider whether drug-eluting stents (DES), heralded devices that have been implanted in four million Americans to prop open clogged arteries, might cause deadly blood clots.
At the center of the controversy are a few issues:
· The challenge of getting patients to take anti-clotting medications for long periods of time after stents are implanted. Patients who stop taking these drugs, primarily one called clopidogrel (Plavix), soon after implantation of a DES may have a higher likelihood of clotting. Many interventional cardiologists who implant drug-eluting stents keep their patients on clopidogrel for a year or longer. Dr. Neal Kleiman, director of cardiac catheterization at Methodist DeBakey Heart Center in Houston, is a national expert on clopidogrel and drug-eluting stents. He implants DES regularly, and he is the national PI on a multi-institutional registry that tracks "real-world" results of DES implants. He was in DC for the FDA panel meetings. He believes patients should count on taking clopidogrel indefinitely after having a drug-eluting stent implanted.
· The benefits of surgery compared to stent implantation. The success of coronary bypass surgery for treating clogged arteries is unmatched. The technology for performing bypass surgery is evolving and includes the use of robotics, "beating-heart" bypass surgery, and less-invasive endoscopic ways of extracting veins for bypass.
o Dr. Michael Reardon, heart surgeon at the Methodist DeBakey Heart Center, has performed thousands of bypasses and is nationally-recognized for his clinical and research contributions to the fields of adult cardiac surgery and coronary artery disease. He also trained at Methodist under Dr. Michael DeBakey.
o Dr. Mahesh Ramchandani, heart surgeon at the Methodist DeBakey Heart Center, is an expert on "beating heart" or "off-pump" surgery, in which the patient's heart is not stopped and put on the heart-lung machine, but instead the bypass is done while the heart is pumping.
o Dr. Gerald Lawrie, heart surgeon at the Methodist DeBakey Heart Center. His regular practice includes of all aspects of thoracic and cardiovascular surgery, and has encompassed many thousands of patients. He has developed special expertise in cardiac valve repair, minimally invasive cardiac surgery, blood conserving surgery, and redo surgeries. Dr. Lawrie trained at Methodist under Dr. Michael DeBakey, the developer of the coronary bypass graft.
We plan to post a commentary (at http://www.methodisthealth.com) by Dr. Kleiman on the FDA meetings he is attending this week in Washington, DC.
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