Smoking Endangers Bypass Surgery Success

By Tommy L. Fudge, M.D.

A prominent heart surgeon I know refuses to perform bypass surgery on any patient who won't quit smoking, on grounds that smoking undoes any good his surgery might accomplish.

That's a little farther than I'd go to make my patients quit smoking. But it's not unjustified. In fact, there's new research that underscores the point.

A 15-year-long study conducted by physicians in Holland disclosed that bypass patients who were still smoking one year after their surgery were more than twice as likely to need another such operation, compared with patients who quit immediately after surgery.

If they persisted in smoking for five years after their surgery, their need for a second bypass was more than three times that of those who stopped immediately.

The Dutch researchers, in an article in the American Heart Association journal Circulation, also reported finding a correlation between continued smoking and an increased risk of angina (heart-related chest pain) and heart attacks among post-bypass smokers.

Perhaps the most encouraging finding was that those who quit smoking immediately after their surgery had about the same post-surgical success as those who had never smoked.

That suggests that even if smoking contributed heavily to the blockage of arteries that necessitated the surgery, by quitting, you very quickly halt its harmful effects on your heart.

Of course, the best way to maximize that benefit is to quit smoking before you reach the point of needing bypass surgery. Quit early enough, and you might never need such surgery at all!

©1999 Cardiovascular Institute of the South