Passing on bypass - A Non-surgical procedure
puts the squeeze on heart patients.

Allen Quijada walked around the San Diego Zoo on
Tuesday. He recently returned from a trip to Florida's
Disney World and delights in telling how he bounced
his grandson on his knee. He regularly goes for long
walks around his neighborhood in Carlsbad.
A few months ago, Quijada couldn't walk across
the street without getting winded.
     "Now, I can do anything," he said. "I can walk
10 miles."
       Quijada, 73, was suffering from angina pectoris,
or blocked arteries, which prevents oxygen from
reaching the heart, causing chest pain, shortness of
breath and other serious problems.
       Three stents had been put into his arteries to
hold them open, and all three had been rejected by his
body, Quijada said. Finally, he heard about Enhanced
External Counterpulsation, a non-surgical procedure
that increases blood flow toward the heart. It causes
new blood vessels called collaterals to grow, creating
in effect an organic bypass.
       Studies of the procedure show it has a success
rate as high as 85 percent, and heart specialists are
seeing it as a serious alternative to major surgery.
The initial reaction from physicians, however, often
is skepticism.
       "I thought it was a joke," Dr. Franklin L.
Murphy said about his first reaction to hearing about
EECP treatment.
       But Murphy, a cardiologist and clinical
professor of medicine at UCLA, now is sold on the
procedure and believes it can replace 90 percent of
bypass surgeries.
       "The surgeons will not be happy with this, but
the patients will," he said.
       Murphy's initial skepticism is understandable,
considering that the procedure sounds like something
hyped on a late-night infomercial.
       Imagine the body being squeezed like a tube of
toothpaste, from the feet to the thighs, as a way of
forcing blood toward the heart.
       Patients lie on a table with pressure cuffs ----
inflatable bands similar to the ones strapped on arms
to take blood-pressure readings ---- secured around
their calves, lower thighs and upper thighs.
       The pneumatic cuffs inflate and deflate in
sequence, first over the calves and then the thighs.
The cuffs, synchronized with an electrocardiogram
machine, are activated when the heart is at rest,
between beats. Pressure on the cuffs is light in the
first sessions but increases gradually until the
patient's body jerks during the procedure.
       In North County, the treatment is provided by
Cardiac Renewal Center in Oceanside, which opened in
2000. Legendary singer Frankie Laine underwent the
procedure at that clinic in 2001.
       Patients go for 35 one-hour treatments over six
or seven weeks. The treatment requires a physician's
prescription and costs between $5,000 and $6,000, but
is covered by most insurance.
       While the centers still are relatively new, the
procedure dates to the 1960s, when therapists used it
to increase blood flow in patients who had suffered
heart attacks. At the time, nobody realized the heart
would respond to the forced blood flow by growing new
vessels.
       "They didn't know that it would do this, but
they indeed found out," Murphy said.
       Kristin Intress, director of sales and marketing
for Cardiac Renewal Centers in Pacific Palisades, said
EECP therapy was first created about 50 years ago in
the United States, but since then has been used mostly
in China, Japan and Europe.
       The Food and Drug Administration approved it for
the United States in 1995, and in January 2000,
Medi-Cal approved its coverage.
       The first Cardiac Renewal Center opened in Los
Angeles two years ago with six beds, and today there
are 10 locations, all within southern California. The
company is the largest provider of the beds used in
the treatment, but it does not have exclusive rights
to the procedure. A cardiologist group can buy a bed
and open a center, for instance, and at least two
other companies also provide the treatment.
       While Murphy said heart surgeons may not be
pleased with a device that could cause them to lose
patients, Intress said Cardiac Renewal Center regional
managers are trying to educate physicians about EECP
in hopes they will refer more patients for the
treatment.
       "When a new product comes out, there's a lot of
fear about how it will affect their patients," said
Intress. But physicians should overcome that fear and
be open to EECP, Intress said, because not all of
their patients are candidates for surgery, and an
alternative treatment could be a matter of life or
death.
       The treatment is painless ---- it's been called
more uncomfortable for people watching it than doing
it ---- and patients often pass the hour listening to
music on headphones or even napping.
       But more important than that for Quijada, the
procedure works.
       Quijada first tried to cure his painful angina,
caused by a artery that was 99 percent blocked, five
years ago. After his body rejected the three stents,
he had a quadruple bypass operation in 1997. But by
2001, one of the bypass arteries had failed.
       "I wasn't getting any blood in there," he said.
"I was going downhill."
       In June, Quijada was wearing nitroglycerin
patches, but he still was in pain and getting weaker.
       "By August, I couldn't walk around the block,"
he said. "If I walked across the street, I had to take
a nitroglycerin pill under my tongue."
       Quijada first heard about EECP from a doctor he
knows from his church. He asked his cardiologist for a
prescription, and his treatment began in October and
was completed Dec. 3.
       "My first thought was, if it sounds too good to
be true, maybe it is," Quijada admitted. "I thought it
was like rubbing chicken bones over it."
       The treatments didn't hurt, but Quijada said he
felt exhausted after coming home from the first five.
       "About the seventh treatment, I started to feel
better," he said. "After the 15th treatment, I walked
from our house down to McDonald's, close to seven
miles."
       Carlsbad resident Clara Kornher, also 73, is
more than halfway through her treatment. She is taking
it as extra insurance after having seven stents
inserted, including five to open blocked heart
arteries.
       "I had every one of my arteries blocked, and I
probably wouldn't have lasted a year if I didn't have
it done," she said.
       She has no complaints about the stents so far,
but she said she didn't feel any stronger after they
were inserted. She and her daughter learned about EECP
from a news show, and she decided to try it to
supplement the stents.
       "I had to have help to walk across the room,"
she said, even after the stents were inserted. "I got
a little better, but I couldn't get the mail."
       Kornher stopped walking with her senior group
because of exhaustion, but since starting the
treatments she has begun again, attempting only a half
mile so far.
       Murphy said most bypass surgeries could be
treated instead with EECP, but he said not everybody
is a candidate for the treatment.
       Those who should not have the treatment include
those who have an aortic aneurysm that requires
surgical repair, severe or moderate aortic
insufficiency or recent blood clots, he said.
       Other than those exceptions, Murphy said, "I
would never recommend bypass surgery for anybody."
If one is not a candidate for surgery or angioplasty and
if drugs are no 1onger quieting his chest pain then. he fits the mold for an EECP patient

EECP is sweeping the country and is available in most states.
Your doctors can tell you whether the
treatment is being tested in your area.

For much more information, and a location in your area, Click here