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GOODBYE" BYPASS -"HELLO' CIIEIATION! A HOSPITAL IS NOT A PLACE TO GET WELL - THE MORBID DETAILS YOU MAY NOT HAVE HEARD ABOUT THE RISKS OF THE BYPASS ITSELF

There are the morbid details you may not have heard about the risks of the bypass itself. • Death occurs in about 5% of heart-bypass surgeries. That is the official National Heart and Lung Institute statistic and is open to question and upward revision. A new study on 3,500 bypass patients, reported in the August 19,1991 issue of JAMA (Journal of the American Medical Association) finds death rates vary from 1.9 percent to 9.2 percent. A companion study found death rates ranging as high as 9.9 percent. Depending on who does the surgery - and where - your chance of leaving the operating room alive could be as low as one in five. • The older you are, the worse your chances. There's a ten percent higher mortality, on average, for every year over seventy, so octogenarians should be particularly wary of being told they are considered suitable surgical candidates. • More to the point, deaths from bypass surgery are increasing, a recent study revealed, perhaps because there are more 'repeaters'. Second and third bypass procedures admittedly expose patients to additional risk. • Women are 77 percent more likely as men to die as a result of bypass surgery, according to a UCLA School of Medicine study of 2,297 male and female bypass patients. The official explanation is that "The women are sicker than the men when they're operated on." We doubt that's the cause, since statistic-wary surgeons routinely repa patients they fear may be too sick to survive- • You could survive the operation, but be all the worse off, nonetheless. Some five to ten percent of bypass patients suffer a heart attack immediately following surgery, according to the New York Heart Association Two percent suffer a stroke and two percent hemorrhage. Heart tissue damage during surgery is common, and usually occurs when the heart suffers oxygen deprivation during the clamping of the aorta. Then when it is resupplied with oxygen-rich blood, the result is a dangerous burst of free radical activity. • You could pull through a 'changed person'. Neurological damage is one of the least publicized hazards of bypass surgery. It causes memory loss, reduced mental functioning, and temperament alteration. Preliminary results of an international study show that the procedure produces subtle, long-lasting mental impairment in nearly one in five. Seventeen percent experience persistent mental difficulties. Up to twenty percent of patients suffer from serious depression for a year or longer.

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