Bypass surgery 'to fail less often'

Bypass surgery is very common

The need for heart patients to undergo repeat bypass surgery may soon be significantly reduced.

Coronary artery bypass surgery is a common technique used to improve blood supply to the heart. Approximately 28,000 operations are carried out each year in UK.

Surgeons use veins from elsewhere in the body, usually the leg, to bypass clogged up areas of the arteries that provide the heart with its own blood supply.

We hope to start clinical trials in about five years

Professor Qingbo Xu

However, on occasions diseased smooth muscle cells may build up in the wall of the vein grafts following surgery. This puts the patient at significantly increased risk of a heart attack, making a repeat bypass operation a necessity.

During the first year after bypass surgery up to 15% of venous grafts begin to fail. After 10 years disease develops in about 50% of cases.

Researchers from St George's Hospital Medical School in south London, hope that they have made a breakthrough that will solve this problem .

They have pinpointed for the first time how these diseased cells begin to form.

Cell markers

By using gene technology to mark cells from the heart tissue and the grafted vein, the researchers have found the diseased cells come from both the original vessel and the newly grafted part.

However, the larger proportion - 60% - come from the donor part.

Knowing the majority of the diseased cells come from the donor piece of vein means it will be possible to develop treatment to make this tissue resist disease.

This treatment can be done once the healthy vein has been removed from the leg, but before it is reinserted into the patient.

Lead researcher Professor Qingbo Xu said: "In the next two years we will work out the best way of treating the vein graft outside of the body, and we hope to start clinical trials in about five years.

"Several methods for ex vivo treatment of the vessel grafts will be tested, including irradiation, gene transfer and new drugs."

Early stages

Alison Shaw, Cardiac Nurse at the British Heart Foundation told BBC News Online that bypass surgery was one of the main treatments for relieving angina (chest pain).

She said: "Any advances to reduce the need for repeat surgery will be welcome news for the 28,000 people in the UK currently undergoing coronary artery bypass surgery each year.

"Although the research is in the very early stages, the future results of clinical trials may help coronary heart disease sufferers in years to come."

The research is published in the journal Circulation Research.