What is the difference between EECP & Heart Bypass surgery ? Which is better!
Question: What is the difference between EECP & Heart Bypass surgery ? Which is better ? Is this treatment successful ?
Answers:
EECP: Enhanced External Counter Pulsations is a new medical therapy for angina.
CABG: Coronary Artery Bypass Graft is an old surgical treatment for angina.
EECP works through "helping the heart".
In coronary artery diseases "angina" the main problem lies in decreased perfusion of blood to the muscle of heart due to blocked or constricted coronary artery, hence the myocardial demand exceeds supply, the heart gets tired and "complains".
EECP helps the heart through making peripheral hearts.
the soleus "calf muscle", historically named the peripheral heart, does pump the blood to circulation during walking, its rhythm however is not consistent with the cardiac rhythm.
By inflating and deflating the soleus and other huge muscles of the lower and sometimes upper limbs, EECP makes the muscles act like accessory peripheral heart that helps the central heart.
when the heart contracts "systole", pumping blood to the body, the cuffs around the muscles deflate making the heart pumps against less resistance and the work is reduced.
when the heart relaxes "diastole", sucking back all the blood that was pumped, the cuffs around the muscles inflate thus pumping the blood back to heart, making life easier for the tired old heart.
There is one more controversial benefit that still resides in the grey area between science and fiction. When the cuffs inflate during diastole, this also increases or prolongs backflow of blood from aorta to the coronary arteries increasing blood perfusion to heart, or even better, increasing the pressure inside the coronary arteries, which can cause angiogenesis leading to formation of new small coronary arteries that provide collateral circulation "bypassing" the blocked coronary artery.
Is this really what happens? is it science or science fiction? not yet proven beyond doubt.
Is it really a treatment? yes, but a palliative treatment more than curative most of the time.
on the other hand, CABG is definitely curative.
It involves removing the defective coronary artery and replacing it with another from other part of the body. what can be more curative than that?
comparing EECP with CABG is not fair. if you have to compare EECP to something you can compare it to PCI "Percutaneous Coronary Intervention", they have similar efficacy
Bottom line: CABG is superior to EECP. CABG can treat triple or more coronary artery constrictions, EECP cant, PCI cant. CABG is most invasive, EECP least invasive.
mohamed has provided an excellent summary, but I must take issue with his statement that "CABG is curative." This is not correct. It is an excellent treatment, but does not treat the underlying disease of atherosclerosis. Without medications and life-style changes, new blockages will develop in most patients (and even in some who do everything right).